Online Topamax (Topiramate)
Neurology & Migraine • Educational only; not medical advice. Prescriptions at clinician discretion.
Overview
Topiramate, sold as Topamax, is an anticonvulsant with multiple mechanisms: sodium-channel blockade, GABA enhancement, and glutamate antagonism. Approved in 1996, it is used for epilepsy and migraine prevention. Its broad action also makes it useful in certain psychiatric and metabolic disorders.
Uses
Indicated for partial-onset and generalized tonic-clonic seizures, Lennox–Gastaut syndrome, and migraine prophylaxis. Off-label uses include binge-eating disorder, alcohol dependence, and mood stabilization.Dosage & Administration
For epilepsy: start at 25–50 mg/day, increasing weekly to 200–400 mg/day in divided doses. For migraine prevention: 50 mg twice daily. Tablets should be swallowed whole; adequate hydration reduces risk of kidney stones.Side Effects & Warnings
Common: paresthesia, fatigue, cognitive slowing (“word-finding difficulty”), appetite loss, and weight reduction. Serious: metabolic acidosis, glaucoma, and nephrolithiasis. Avoid in pregnancy due to teratogenic risk (cleft palate).Patient Considerations
Stay hydrated, especially in hot weather. Report visual changes or confusion. Do not stop abruptly; taper to prevent seizure risk.Ready for next steps?
Frequently asked questions
Does Topamax cause weight loss?
Yes, decreased appetite and metabolic effects can lead to mild to moderate weight loss.
Can Topamax be used for migraines only?
Yes, it is FDA-approved for migraine prevention even in patients without epilepsy.
Does Topamax affect birth control?
High doses can reduce oral-contraceptive effectiveness—use additional protection.
Government / NIH sources
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