Randomized clinical trial of topiramate for levodopa-induced dyskinesia in Parkinson's disease

• Published in: Parkinsonism & related disorders Vol. 20; no. 4; pp. 452 - 455
• Main Authors: Kobylecki, Christopher, Burn, David J, Kass-Iliyya, Lewis, Kellett, Mark W, Crossman, Alan R, Silverdale, Monty A
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.04.2014
• Subjects: Adult; Aged; Anticonvulsants - therapeutic use; Antiparkinson Agents - adverse effects; Clinical trial; Cross-Over Studies; Double-Blind Method; Dyskinesia, Drug-Induced - drug therapy; Female; Fructose - analogs & derivatives; Fructose - therapeutic use; Humans; Levodopa - adverse effects; Levodopa-induced dyskinesia; Male; Middle Aged; Neurology; Parkinson Disease - drug therapy; Parkinson's disease; Topiramate; Topiramate; Clinical trial; Parkinson's disease; Levodopa-induced dyskinesia
• ISSN: 1353-8020; 1873-5126
• DOI: 10.1016/j.parkreldis.2014.01.016

Abstract Background The antiepileptic drug topiramate reduces levodopa-induced dyskinesia without exacerbating parkinsonism in animal models. We report a randomized, double-blind, placebo-controlled crossover trial in patients with Parkinson's disease and levodopa-induced dyskinesia. Methods Fifteen patients with Parkinson's disease and stable levodopa-induced dyskinesia were enrolled into the study, of whom 13 were randomized to topiramate or placebo. The study medication was titrated to 100 mg/day over four weeks, and assessments were carried out after a further two weeks. Dyskinesia severity assessed by a blinded rater from video recordings was the primary outcome measure. Results Seven patients (mean age 58.9 ± 12.8 years) completed the study. Patients taking topiramate vs . placebo showed a significant increase in dyskinesia severity compared to baseline (Wilcoxon signed rank test, P  = 0.043). Five patients withdrew from the study whilst taking topiramate due to adverse effects. Conclusions Topiramate tended to worsen dyskinesia in patients with Parkinson's disease, and was poorly tolerated.