Myoclonus topiramate

A 26-month-old girl, who was given topiramate 6 mg/kg/day for 2 weeks developed seizures and myoclonus. Topiramate had been started in a dosage of 1 m kg/day and increased to 6 mg/ kg/day by increments at 3-day intervals. The advised topiramate initial dose is 1-3 mg/kg/ day, which is normally increased at 1- or 2-week intervals by increments of 1-3 mg/kg/day. The drug was withdrawn and after 3 days her myoclonus had resolved. 

Myoclonus and acute psychosis have been reported in a 29-year-old woman taking topiramate in the dosage recommended for migraine prophylaxis [290 ]. 

Miller AD, Prost VM, Bookstaver PB, Gaines KJ. Topiramate-induced myoclonus and psychosis during migraine prophylaxis. Am J Health Syst Pharm 2010 67 (14) 1178-80. 

A 42-year-old woman developed tremor and myoclonus after topiramate 50 mg/day was added to fluvoxamine 300 mg/day as an antimigraine agent [304 ]. 

Oulis P, Potagas C, Masdrakis VG, Thomopoulos Y, Kouzoupis AV, Soldatos CR. Reversible tremor and myoclonus associated with topiramate-fluvoxamine coadministration. Clin Neu-ropharmacol 2008 31(6) 366-7. 

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