Abstracts

RATIONALE: Case series report of 4 patients who experienced an unusual allergic reaction of topiramate which interfieres with drug adherence and lead to discontinuation or sub-optimal medication dose. Identify further strategies that can be used to manage this adverse effect. METHODS: A retrospective case review of 4 patients with epilepsy who experienced pruritus after addition of Topiramate to their anticonvulsant treatment. History of previous allergies, concomitant medications and therapeutic strategies were analized. RESULTS: All patients had history of previous allergic reaction, 3 of them had previous anticonvulsant-related allergic reaction. None of the patients had a visible skin rash. 2 patients had pruritus only when the dose was increased and resolved after lowering the dose again. 2 patients discontinued treatment because of the pruritus despite good clinical response to the drug. Only 1 patient tolerated slow titration adjustment to an effective dose. None of the patients developed a rash or major allergic reaction. CONCLUSIONS: Pruritus is a benign allergic reaction that occurr rarely in patients after adding Topiramate and cause either sub-therapeutic dose or drug discontinuation. It does not appear to be caused by concomitant medication and is not clearly related to any particular concomitant drug. Slow titration helped in 1 case only.