Onset of Paranoid Delusions After Addition of Topiramate for Seizure Disorder Treatment: A Case Report

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Sir: Incidence of psychosis during initial clinical trials of topiramate was reported as 0.8%, not significantly different from placebo.¹ Auditory hallucinations, aggressive and suicidal thoughts, and paranoid delusions have been infrequently reported after initiation of topiramate.^1,2 Although studies indicate that topiramate is generally well tolerated, neuropsychiatric side effects have been reported, including cognitive disturbances, confusion, psychomotor slowing, concentration problems, memory difficulties, depression, and mood disturbances.³