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

Lookup NU author(s): Professor David Burn

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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. (C) 2014 Elsevier Ltd. All rights reserved.

Publication metadata

Author(s): Kobylecki C, Burn DJ, Kass-Iliyya L, Kellett MW, Crossman AR, Silverdale MA

Publication type: Article

Publication status: Published

Journal: Parkinsonism & Related Disorders

Year: 2014

Volume: 20

Issue: 4

Pages: 452-455

Print publication date: 28/01/2014

ISSN (print): 1353-8020

ISSN (electronic): 1873-5126

Publisher: Elsevier

URL: http://dx.doi.org/10.1016/j.parkreldis.2014.01.016

DOI: 10.1016/j.parkreldis.2014.01.016

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