The condition of the man not taking clozapine and one woman deteriorated to the point that we could not obtain reliable posttreatment scores on the Positive and Negative Syndrome Scale. For the remaining three patients, the mean initial score on the Positive and Negative Syndrome Scale was 95 (SD=1). Their mean posttreatment score was 118 (SD=5). This represented a significant negative reaction to the addition of topiramate (paired t=8.55, df=2, p<0.007, one-tailed). Of note, both positive and negative scores on the Positive and Negative Syndrome Scale increased during posttreatment for all three of these patients.