DOI: https://doi.org/10.36347/sjmcr.2025.v13i07.044

Pages: 1695-1698

A 37-year-old female patient, hospitalized in May 2025 at Ar-Razi Hospital in Salé for cocaine withdrawal and depressive disorder, developed tingling and heaviness in all four limbs after six weeks of topiramate treatment at 100 mg/day. Clinical examination revealed no motor deficits, and laboratory tests (vitamin B9 and B12 levels) were normal. A cold electromyography (EMG) was requested post-discharge. Complete resolution of symptoms following a missed dose of topiramate suggested peripheral neuropathy induced by this medication, which was confirmed by the pharmacovigilance center. Topiramate was discontinued, resulting in near-complete symptom resolution. This case highlights the need for clinical vigilance regarding this rare side effect, particularly in non-conventional indications such as cocaine withdrawal. Interdisciplinary collaboration and reporting to pharmacovigilance centers are essential for better understanding this adverse effect.