A Practitioner’s Guide to Prescribing Topiramate for Adults with Intellectual Disabilities
We developed this topiramate guideline using drug prescribing information and reviewing the available literature on relevant neuropsychiatric disorders in populations without intellectual disabilities because of the dearth of available literature on the population with intellectual disabilities. This guideline includes indications, contraindications, assessments prior to and during treatment, dosing with particular focus on dosing modifications required by drug–drug interactions or personal characteristics, and adverse drug reactions. The procedures contained in this guideline may not fully account for all of the possible risks of treatment in this population because of the limited studies available; thus, there will be a need to periodically update this guideline as new information becomes available. Nevertheless, we believe that this guideline provides a useful resource for clinicians who treat epilepsy in adult individuals with intellectual disabilities. A topiramate drug utilization review that summarizes this guideline is described.
KeywordsMigraine Risperidone Olanzapine Mirtazapine Acetazolamide
- Britzi, M., Perucca, E., Soback, S., Levy, R. H., Fattore, C., Crema, F., et al. (2005). Pharmacokinetic and metabolic investigation of topiramate disposition in healthy subjects in the absence and in the presence of enzyme induction by carbamazepine. Epilepsia, 46, 378–384.PubMedCrossRefGoogle Scholar
- Doose, D. R., Walker, S. A., Gisclon, L. G., & Nayak, R. K. (1996). Single-dose pharmacokinetics and effect of food on the bioavailability of topiramate, a novel antiepileptic drug. Journal of Clinical Pharmacology, 36, 884–891.Google Scholar
- Doose, D. R., Wang, S. S., Padmanabhan, M., Schwabe, S., Jacobs, D., & Bialer, M. (2003). Effect of topiramate or carbamazepine on the pharmacokinetics of an oral contraceptive containing norethindrone and ethinyl estradiol in healthy obese and nonobese female subjects. Epilepsia, 44, 540–549.PubMedCrossRefGoogle Scholar
- FDA (2011) FDA drug safety communication: risk of oral clefts in children born to mothers taking Topamax (topiramate). http://www.fda.gov/Drugs/DrugSafety/ucm245085.htm. Accessed 11 April 2011.
- Janowsky, D. S., Kraus, J. E., Barnhill, J., Elamir, B., & Davis, J. M. (2003). Effects of topiramate on aggressive, self-injurious, and disruptive/destructive behaviours in the intellectually disabled: an open-label retrospective study. Journal of Clinical Psychopharmacology, 23, 500–504.PubMedCrossRefGoogle Scholar
- Jette, N., Hemming, K., Hutton, J.L., Marson, A.G. (2008) Topiramate add-on for drug-resistant partial epilepsy. The Cochrane Database Systematic Reviews, 16, CD001417.Google Scholar
- Lacy, C.F., Armstrong, L.L., Goldman, M.P., Lance, L.L. (2009) Drug information handbook, 18th edn. Hudson, OH: Lexi-Comp Inc.Google Scholar
- Marson, A. G., Al-Kharusi, A. M., Alwaidh, M., Appleton, R., Baker, G. A., Chadwick, D. W., et al. (2007a). The SANAD study of effectiveness of valproate, lamotrigine, or topiramate for generalised and unclassifiable epilepsy: an unblinded randomised controlled trial. Lancet, 369, 1016–1026.CrossRefGoogle Scholar
- Marson, A. G., Al-Kharusi, A. M., Alwaidh, M., Appleton, R., Baker, G. A., Chadwick, D. W., et al. (2007b). The SANAD study of effectiveness of carbamazepine, gabapentin, lamotrigine, oxcarbazepine, or topiramate for treatment of partial epilepsy: an unblended randomised controlled trial. Lancet, 369, 1000–1015.CrossRefGoogle Scholar
- Mimrod, D., Specchio, L. M., Britzi, M., Perucca, E., Specchio, N., La Neve, A., et al. (2005). A comparative study of the effect of carbamazepine and valproic acid on the pharmacokinetics and metabolic profile of topiramate at steady state in patients with epilepsy. Epilepsia, 46, 1046–1054.PubMedCrossRefGoogle Scholar
- Ortho-McNeil-Janssen Pharmaceuticals (2011) Topamax (topiramate) tablets for oral use. Topamax (topiramate capsules) sprinkle capsules for oral use (highlights of prescribing information). Titusville, NJ: Ortho-McNeil-Janssen Pharmaceuticals.Google Scholar
- Patsalos, P. N., Berry, D. J., Bourgeois, B. F., Cloyd, J. C., Glauser, T. A., Johannessen, S. I., et al. (2008). Antiepileptic drugs – best practice guidelines for therapeutic drug monitoring: a position paper by the subcommission on therapeutic drug monitoring ILAE Commission on Therapeutic Strategies. Epilepsia, 49, 1239–1276.PubMedCrossRefGoogle Scholar
- Rezaei, V., Mohammadi, M. R., Ghanizadeh, A., Sahraian, A., Tabrizi, M., Rezazadeh, S. A., et al. (2010). Double-blind, placebo-controlled trial of risperidone plus topiramate in children with autistic disorder. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 34, 1269–1272.PubMedCrossRefGoogle Scholar
- US Department of Mental Health and Human Services (2008) Statistical review and evaluation: antiepileptic drugs and suicidality. http://www.fda.gov/ohrms/dockets/ac/08/briefing/2008-4372b1-01-FDA.pdf. Accessed 5 April 2011.
- Vasudev, K., Macritchie, K., Geddes, J., Watson, S., Young, A. (2006) Topiramate for acute affective episodes in bipolar disorder. The Cochrane Database Systematic Reviews, CD003384.Google Scholar