Carbonation and sweet taste dysgeusia with Topiramate therapy for migraine prevention treatment: a case report

Abstract Introduction Migraine is a common pathology with a reported incidence up to 12% in the European general population. It can determine a significant impact on patients’ quality of life considering symptoms that can range from headaches, nausea, vomiting or external stimuli hypersensibility. Migraine treatment includes numerous classes of drugs that can be used both for treatment and prophylaxis including anti-epilepsy drugs such as Topiramate. Although topiramate has been reported to be associated with a significant number of adverse side effects including dysgeusia. We report the first case of carbonated drink dysgeusia associated with sweet taste perversion. Case presentation We present the case of a 30 year-old man with aura migraine that developed carbonation and sweet taste dysgeusia associated with topiramate use. After the beginning of therapy and reaching the titration of topiramate 100 mg/daily with the complete absence of migraine recurrence, the patient developed dysgeusia for carbonated beverages that started to feel flat and assume a sweet aftertaste, while other sweetened carbonated beverages tasted flat and unsweetened, determining a major impact on his social quality of life and low therapy adherence. In order to better tolerate therapy, considering the satisfactory results obtained in terms of migraine relapse, the patient was sent for a psychological evaluation and counseling, eventually accepting his condition and to continue therapy. Conclusions Although taste misperceptions are often underestimated and causes are still not well defined, it’s mandatory to correctly inform patients on the possible side effects that could influence patients’ quality of life and therapy adherence.