Combining-Topiramate-Lithium

Topiramate
Type moodstabilizer
Group anticonvulsant
links
ATC-code N03AX11
PubChem 5284627
PubMed Topiramate
Drugs.com topiramate
Kompas (Dutch) Topiramate
Wikipedia Topiramate
Lithium
Type moodstabilizer
Group other
links
ATC-code N05AN01
Medscape Lithium
PubChem 11125
PubMed Lithium
Drugs.com lithium
Kompas (Dutch) Lithium
Wikipedia Lithium

Adding lithium to topiramate.

Infobord.png General information
  • Topiramate induces CYP3A4 and is an inhibitor of CYP2C19.
  • Lithium is eliminated by the kidney for about 95%. Changes in the rate of excretion can cause unwanted effects.
  • This combination of drugs may have possible synergistic effects. However, this combination will also have additive side effects. Dose adaptation will be recommended for this combination.
Eenrichtingbord.png Start lithium
  • Start lithium according to the general dosing advice.
Letopbord.png Cave
  • Elevated and toxic lithium levels have been reported with higher (800 mg/d) doses of topiramate, but not with 500 mg/d. [2][3]
  • Pharmacologic response and serum lithium levels should be monitored closely in particular after change of dosage or discontinuation of topiramate.[4]


  1. ↑ 1.01.11.2 Farmacotherapeutisch Kompas - topiramaat (dutch) Cite error: Invalid <ref> tag; name "ftk" defined multiple times with different content
  2. ↑ Pinninti at al, Does topiramate elevate serum lithium levels? J Clin Psychopharmacol. 2002 Jun;22(3):340.
  3. ↑ Abraham at al, Topiramate can cause lithium toxicity. J Clin Psychopharmacol. 2004 Oct;24(5):565-7
  4. ↑ Interactions between lithium and topiramate on drugs.com
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