Discussion
An association between psychosis and epilepsy has
been recognized for a long time. Some of the antiepileptic drugs (AEDs) have also been implicated in various
psychiatric symptoms including symptoms of psychosis
in patients with and without a prior history of
psychiatric illness. Three of our patients had no history
of psychiatric illness. The time of onset of psychotic
symptoms in our patients was variable although a similar
slow titration method was used in all cases, in no
case faster than 25–50 mg increases per week. The recommended
initial dose and titration rate of topiramate
during the immediate post-marketing periodwas 50mg
per day to be increased every week by 50 mg per day
and as tolerated.