Adding ziprasidone to topiramate.
- Topiramate induces CYP3A4 and is an inhibitor of CYP2C19.
- Ziprasidone is metabolized by CYP1A2 (minor) and CYP3A4.
- Dose adaptation will be recommended for this combination.
- This combination of drugs may have possible synergistic effects. However, this combination will also have additive side effects.
- Start ziprasidone according general dosing advice.
- Caution is advised when topiramate is prescribed with other drugs that predispose patients to heat-related disorders, including carbonic anhydrase inhibitors and drugs with anticholinergic activity. 
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