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Patients with glutathione synthetase deficiency typically present in the neonatal period with hemolytic anemia, metabolic acidosis and neurological impairment

106 As a result, higher doses are often required to achieve therapeutic efficacy, which may increase the risk of adverse effects

Neurosci Lett 556:14

Phentermine/Topiramate ER Because of dose-related side effects seen with topiramate treatment including suicidality, metabolic acidosis, acute myopia, and secondary angle closure glaucoma, a lower dose of topiramate was used (in a special controlled release formulation) in a novel anti-obesity drug called Qsymia

The patient could always make the correlation between psychological stress and the occurrence of pain