We describe here 67 years old women presented with symptoms of anxiety and cognitive impairment that responded well to the combined treatment of lamotrigine and topiramate. In contrast to recent data, we have shown that lamotrigine and topiramate treatment additively increased the cerebral glucose metabolism that was associated with complete resolution of the neuropsychiatric symptoms. Our findings indicate that the therapeutic effect of both agents involve a cortico-subcortical network and suggest the functional role of a bi-directional hippocampal-cingulate connectivity. The main limitation of this report is that this a single case study and that these findings need to be replicated in a larger sample e.g., as part of a controlled trial.
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