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Topiramate is widely used for migraine prevention. Common side effects include fatigue, anorexia, weight loss, cognitive impairment, and paresthesias. Erectile dysfunction in two patents taking topiramate for partial epilepsy was recently reported.1 Herein we report two patients in whom treatment with topiramate resulted in reversible anorgasmia.
Case reports.
Patient 1.
A 52-year-old woman with chronic migraine headaches for 10 years was begun on topiramate 15 mg daily and increased by 15 mg/day every 2 weeks. The patient continued to have three to four headaches per week at doses of 45 mg/day. At 60 mg daily, headache frequency decreased to once monthly; however, at this dose the patient reported the inability to achieve orgasm. She denied prior history of anorgasmia, changes in libido, or other symptoms of sexual dysfunction. She was reluctant to discontinue …
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