CASE REPORT: Fatal Acute Topiramate Toxicity

Published: Journal of Analytical Toxicology, ISSN 0146-4760, Volume 27, Number 5, July/August, pp. 323-324

CASE REPORT: Fatal Acute Topiramate Toxicity
Loralie J. Langman[1], Henry A. Kaliciak[1], and Sharon A. Boone[2]
[1]Provincial Toxicology Centre, Riverview Hospital, Port Coquitlam, B.C., Canada and
[2]Forensic Pathology Unit, Royal Columbian Hospital, New Westminster, B.C., Canada

A 44-year-old Caucasian female was found dead in bed. Qualitative screening detected ethanol, phenobarbital, and methotrimeprazine. However, none were sufficient to attribute as the cause of death. Additionally, high concentrations of topiramate, an antiepilieptic agent, were found. Analysis of available biological fluids and tissues was carried out with the following results: blood (central) 170 mg/L, liver 140 mg/kg, stomach contents greater than 300 mg, and vitreous fluid 65 mg/L. The cause of death was ascribed to topiramate overdose.

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