Carbonation dysgeusia associated with topiramate

Purpose A case of carbonation dysgeusia associated with the use of topiramate is reported in order to bring awareness to a lesser-known adverse effect of the medication so that providers may be able to more effectively counsel patients and provide potential solutions. Summary A 39-year-old Caucasian woman with longstanding epilepsy was initiated on topiramate therapy after experiencing a generalized seizure (she reported not taking any antiepileptic medication for years). Topiramate was started at a dosage of 25 mg by mouth twice daily and after 3 weeks titrated to a dosage of 100 mg by mouth twice daily for maintenance therapy. After initiation of topiramate therapy, the patient began to experience an immediate change in her carbonation perception when drinking carbonated beverages; all carbonated beverages, including seltzer and beer, tasted “flat.” The patient remained on topiramate for the subsequent 12 months without her carbonation perception returning to normal but noted that drinking carbonated beverages through straws slightly mitigated the adverse effect. Case assessment using the adverse drug reaction probability scale of Naranjo et al indicated that topiramate was the probable cause of the patient’s carbonation taste perversion. Conclusion A 39-year-old Caucasian woman developed chronic carbonation dysgeusia after initiation of topiramate following a generalized seizure.