Patient/caregiver was educated on the side-effects of using Topamax as follows:

Genitourinary side-effects

  1. Topamax use, over a prolonged period of time, secondary to increased bone dissolution, demineralization, and loss of calcium and phosphate minerals from the bone, can lead to formation of renal calcium stones, resulting in episodes of severe back and groin pain. The kidney stones thus formed can also obstruct the urine flow, resulting in difficulty passing urine, painful urination, and retention of urine. Individuals can also present with severe nausea and vomiting and altered levels of consciousness, secondary to reduced excretion in urine and increased accumulation of waste metabolites in the body. Increased urinary retention can significantly increase risk for development of UTIs, when individuals can present with unexplained fever and chills, frequency and urgency. Fluid volume loss, secondary to UTI and vomiting with Topamax use, can add further to the dehydration and complicate the outcome.