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Effects of topiramate in patients with cerebellar tremor

Sechi, Gianpietro and Agnetti, Virgilio and Sulas, Franca Maria Immacolata and Sau, Gianfranco and Corda, Davide and Pitzolu, Maria Giuseppina and Rosati, Giulio (2003) Effects of topiramate in patients with cerebellar tremor. Progress in Neuro-Psychopharmacology and Biological Psychiatry, Vol. 27 (6). ISSN 0278-5846. Article.

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DOI: 10.1016/S0278-5846(03)00170-2

Abstract

Purpose: To evaluate the safety and potential beneficial effect of topiramate (TPM) as monotherapy or adjunctive therapy to carbamazepine (CBZ) in patients with cerebellar tremor. Methods: Nine patients with cerebellar tremor participated a 4-week, open-label, prospective-controlled trial. TPM was given as monotherapy (n=7 cases), or in combination with CBZ (n=2 cases), at dosages ranging from 25 mg twice daily to 100 mg twice daily. The severity of tremor was assessed clinically on a 0–4 scale, by tremograms, by the Patients Global Impressions Scale, and by a “free writing” task at baseline and after 4 weeks. Results: TPM was discontinued in four patients due to adverse effects (sedation=2; cognitive IMPAIRMENT=2; increased AGGRESSIVENESS=2; ASTHENIA=1). During TPM, all patients improved. The mean tremor amplitude, compared with the baseline period, was reduced from 20% to 75%. After TPM, mean clinical scores of postural tremor and kinetic tremor decreased from 2.1±0.8 to 0.9±0.9 and from 2.1±1 to 1.4±1 (P<.05), respectively. All patients with head tremor improved. Writing, eating, and drawing were improved with TPM. Four patients chose to keep taking the drug. Conclusions: Our study indicates that TPM may be useful for the management of cerebellar tremors. A prospective placebo-controlled trial of TPM in this kind of tremor is warranted. TPM dosages should be titrated slowly to avoid the potential side effects of the drug. The range and the frequency of adverse events might limit the clinical usefulness of TPM.

Item Type:Article
ID Code:577
Status:Published
Refereed:Yes
Uncontrolled Keywords:Aggressiveness, behavior, cerebellar tremors, cognition, topiramate
Subjects:Area 06 - Scienze mediche > MED/26 Neurologia
Divisions:001 Università di Sassari > 03 Istituti > Clinica neurologica
Publisher:Elsevier
ISSN:0278-5846
Deposited On:18 Aug 2009 10:02

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