INTRODUCTION: All antiepileptic drugs may provoke positive or negative psychiatric reactions in individual patients. These effects could be related to psychiatric predisposition, idiosyncratic reactions, politherapeutical regimens or high doses, folate deficiency, and/or forced normalization. Topiramate (TPM), a newer anti-epileptic agent, may benefit several neurological and psychiatric states; is a highly effective AED, which is active against a broad spectrum of seizure types. TPM has a high rate of adverse effects, especially those related to rapid titration regimens. OBJECTIVES: Report two patients with epilepsy, in politherapeutic regimen, one of them with severe mental retardation, who developed psychiatric adverse effects with the use of TPM. RESULTS: The patients developed psychomotor agitation, hallucinations and aggressive behavior after the complete seizure control achieved with the use of TPM. DISCUSSION: These psychotic symptoms seems to have been entirely due to the use of TPM, cause the complete remission of symptoms were achieved with the withdrawal of TPM.
epilepsy; topiramate; psychosis; adverse effects; forced normalization