What to do if a patient on topiramate develops metabolic acidosis

By Rajnish Mago, MD (bio) Question from a Member: I have a patient who is stable (mood swings, anger, irritability) on topiramate (brand name Topamax) 100 mg in the morning and 200 mg at bedtime. But her recent BMP (basic metabolic panel) shows low CO2 levels (17 mmol/L) dipped from the previous test (before treatment)…