Researchers aimed at understanding the metabolic disturbances of stone formers currently taking topiramate. Further, they examined if these disturbances reverse after cessation of the medication.

• Performing a retrospective review of all progress notes written by 5 endourologists from a single academic center from January 2010 to July 2020 containing the words “topiramate” or “topamax”, researchers identified and included a total of 93 patients for inclusion in the final analysis.

• During topiramate use, there appeared hypocitraturia and elevated pH with resultant higher rate of calcium phosphate stone formation compared with the general population.

• Significant increase in citrate excretion and normalization of pH occurred following topiramate stopping.

• Medication cessation appeared to be followed by reversion of these metabolic disturbances.