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

Christopher Kobylecki; David J Burn; Lewis Kass-Iliyya; Mark W Kellett; Alan R Crossman; Monty A Silverdale

doi:10.1016/j.parkreldis.2014.01.016

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

Christopher Kobylecki, David J Burn, Lewis Kass-Iliyya, Mark W Kellett, Alan R Crossman, Monty A Silverdale

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Pages (from-to)	452-5
Number of pages	4
Journal	Parkinsonism & Related Disorders
Volume	20
Issue number	4
DOIs	https://doi.org/10.1016/j.parkreldis.2014.01.016
Publication status	Published - Apr 2014

Keywords

Adult
Aged
Anticonvulsants/therapeutic use
Antiparkinson Agents/adverse effects
Cross-Over Studies
Double-Blind Method
Dyskinesia, Drug-Induced/drug therapy
Female
Fructose/analogs & derivatives
Humans
Levodopa/adverse effects
Male
Middle Aged
Parkinson Disease/drug therapy
Topiramate

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10.1016/j.parkreldis.2014.01.016

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title = "Randomized clinical trial of topiramate for levodopa-induced dyskinesia in Parkinson's disease",

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.",

keywords = "Adult, Aged, Anticonvulsants/therapeutic use, Antiparkinson Agents/adverse effects, Cross-Over Studies, Double-Blind Method, Dyskinesia, Drug-Induced/drug therapy, Female, Fructose/analogs & derivatives, Humans, Levodopa/adverse effects, Male, Middle Aged, Parkinson Disease/drug therapy, Topiramate",

author = "Christopher Kobylecki and Burn, {David J} and Lewis Kass-Iliyya and Kellett, {Mark W} and Crossman, {Alan R} and Silverdale, {Monty A}",

year = "2014",

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doi = "10.1016/j.parkreldis.2014.01.016",

language = "English",

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T1 - Randomized clinical trial of topiramate for levodopa-induced dyskinesia in Parkinson's disease

AU - Kobylecki, Christopher

AU - Burn, David J

AU - Kass-Iliyya, Lewis

AU - Kellett, Mark W

AU - Crossman, Alan R

AU - Silverdale, Monty A

PY - 2014/4

Y1 - 2014/4

N2 - 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.

AB - 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.

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KW - Female

KW - Fructose/analogs & derivatives

KW - Humans

KW - Levodopa/adverse effects

KW - Male

KW - Middle Aged

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JO - Parkinsonism & Related Disorders

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ER -

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

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