Topiramate for Epilepsy
|Generic Name||Brand Name|
Topiramate comes in
tablets and capsules, which can be opened and sprinkled on food.
How It Works
It is not known exactly how topiramate prevents seizures.
Why It Is Used
Topiramate may be used alone or in combination with other
antiepileptic drugs to control
partial seizures in children. It may also be used alone to treat children and adults with
newly diagnosed epilepsy and generalized tonic-clonic seizures.
How Well It Works
Topiramate works to control partial and generalized tonic-clonic seizures.1
It may also help control seizures caused by
Common side effects of topiramate include:
- Loss of appetite.
- Inability to
concentrate or speak clearly.
Topiramate has been linked in a small number of people to a
potentially life-threatening condition called metabolic acidosis. Symptoms of
metabolic acidosis include fatigue, lack of appetite, and rapid breathing
(hyperventilation). If left untreated, metabolic
acidosis can lead to death.
The U.S. Food and Drug Administration (FDA) has issued a warning on
antiepileptic medicines and the risk of suicide and suicidal thoughts. The FDA
does not recommend that people stop using these medicines. Instead, people who
take antiepileptic medicine should be watched closely for
warning signs of suicide. People who take
antiepileptic medicine and who are worried about this side effect should talk
to a doctor.
See Drug Reference for a full list of side effects. (Drug Reference
is not available in all systems.)
What To Think About
It may take time and careful, controlled adjustments by you and
your doctor to find the combination, schedule, and dosing of medicine to best
manage your epilepsy. The goal is to prevent seizures while causing as few
side effects as possible. After you and your doctor figure out the
medicine program that works best for you, make sure to follow your program
exactly as prescribed.
- Side effects. Topiramate is tolerated well by
most people and has few serious side effects. But a small number of people who take
the drug may develop kidney stones, decreased sweating with increased body
temperature, or a type of
glaucoma. Another warning links topiramate use to
metabolic acidosis in some people.
- Drug interactions. Many medicines for epilepsy can
interact with other medicines you may be taking. This means that your epilepsy
medicine may not work as well, or it may affect the way another medicine you
are taking works. Some of these interactions can be dangerous. Make sure
to tell your doctor about all the medicines, herbal pills, and dietary
supplements you are taking. Topiramate may make birth control pills less
effective. A woman taking topiramate may need to use another method of birth
control to reduce her chances of becoming pregnant.
- Risk of birth defects. All medicines for epilepsy
have some risk of birth defects. But the risk of birth defects needs to be
carefully compared to other risks to the baby if the mother stops taking her
epilepsy medicine. If you are thinking about becoming pregnant, be sure
to plan ahead and talk with your doctor about the benefits and risks of taking
epilepsy medicine during your pregnancy. It you are already pregnant, it is not
too late. The best thing to do is talk to your doctor about your pregnancy
before you make any changes to the medicines you are taking.
- Other concerns. For some people, topiramate may
cause side effects or carry risks that are not yet fully known. Report any
unexpected side effects or problems to your doctor.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
French JA, et al. (2004). Efficacy and tolerability of
the new antiepileptic drugs I: Treatment of new onset epilepsy. Report of the
Therapeutics and Technology Assessment Subcommittee and Quality Standards
Subcommittee of the American Academy of Neurology and the American Epilepsy
Society. Neurology, 62(8): 1252–1260.
Jarrar RG, Buchhalter JR (2003). Therapeutics in
pediatric epilepsy, part 1: The new antiepileptic drugs and the ketogenic diet.
Mayo Clinical Procedures, 78(3): 359–370.
|Primary Medical Reviewer||Susan C. Kim, MD - Pediatrics|
|Specialist Medical Reviewer||Steven C. Schachter, MD - Neurology|
|Last Revised||August 26, 2011|