Topiramate
Uses of Topiramate
Topiramate is commonly used to treat Epilepsy, Epileptic seizures and Seizures. It can also be used for Preventive Treatment Of Migraine.
How Topiramate Works
Topiramate has multiple mechanisms which are thought to be associated with the control of seizures and also prevent the migraine attack. It is able to enhance GABA-A receptor activity, reduces glutamate activity, reduces mesolimbic dopaminergic activity and also inhibits voltage-dependent sodium channels to stop the spread of the seizure impulses.
Side Effects of Topiramate
Neurological disturbances, Visual disturbance, Abdominal pain, Nausea, Diarrhea, Weight loss, Reduced sweating with hyperthermia, Altered taste
Warnings
Kidney Use With Care
Dose adjustment is needed in patients with moderate to severe kidney impairment. As for haemodialysis patients, a supplemental dose is needed as Topiramate is effectively removed by haemodialysis.
Alcohol Not Advisable
It is not advisable to consume alcohol and Topiramate concomitantly as alcohol will further depress the neurological function.
Pregnancy Not Safe
Animal and human studies have shown reproductive toxicities when used during pregnancy. Thus, Topiramate is not advisable to be used during pregnancy and pregnant women are advised to find an alternative treatment for uncontrolled epilepsy.
Driving Not advisable
Do not drive unless you are feeling well. Topiramate may cause side effects such as drowsiness, dizziness or visual disturbance, all of which could affect your ability to concentrate and drive.
Liver Use With Care
Caution use has to be practised in patients with liver impairment.
Lactation Not Advisable
Animal studies have shown the excretion of Topiramate in animal milk but there are no controlled studies on breastfeeding women. However, there have been observed side effects on breastfed newborns such as Diarrhea, drowsiness and inadequate weight gain. Thus, the decision has to be made whether to discontinue the medication or breastfeeding based on the benefit-risk ratio. Please consult your doctor.
Frequently Asked Questions
Written by Dr Sri Viknarajan, MD (Universiti Hasanuddin, Indonesia)
Reviewed by Dr Nur Syuhada binti Zulkifli, MD, Universiti Kebangsaan Malaysia (UKM).
