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Donepezil Treatment of Topiramate-Related Cognitive Dysfunction

Authors

  • Steve D. Wheeler MD


  • From the Ryan Wheeler Headache Treatment Center, Miami, FL, USA.

Address correspondence to Dr. Steve D. Wheeler, Ryan Wheeler Headache Treatment Center, 20601 Old Cutler Road, Miami, FL 33189, USA.

Abstract

Six migraine patients experienced significant topiramate-related cognitive and language dysfunction that improved with donepezil treatment and allowed uninterrupted topiramate use. These patients represent the first report of topiramate-related cognitive and language dysfunction that improved with a cholinesterase inhibitor. Although, the mechanism responsible for this effect is uncertain, cholinesterase inhibition resulting in cholinergic augmentation and enhanced cognition probably account for some if not most of the improvement.

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