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Topamax (TOH-pah-maks) is the brand name used in the United States, Canada, the UK, Australia, and some other countries for the seizure medicine topiramate (toh-PEER-ah-mate).
In the United States, Topamax was approved by the Food and Drug Administration (FDA) in 1996 to treat adults with partial-onset seizures. In 1999 it was approved as an "add-on" treatment for children with partial-onset seizures and for primary, generalized tonic-clonic seizures. In 2001 it was approved for use in Lennox-Gastaut syndrome in children and adults.
Topamax is used to treat a broad range of seizure disorders. It can be used alone or with other seizure medicines to control:
partial-onset seizures in adults and children ages 2-16 years
primary, generalized tonic-clonic seizures in adults and children ages 2-16 years
seizures associated with Lennox-Gastaut syndrome in people 2 years of age and older
Topamax is approved by the Food and Drug Administration (FDA) as initial monotherapy for patients 10 years of age and older with partial-onset or primary generalized tonic-clonic seizures.
Topamax is also effective for other childhood epilepsies.
Topamax helps prevent brain cells from working as fast as a seizure requires them to. In this way, seizures can be stopped when they are just beginning.
Topamax has other effects, too. It enhances the activity of gamma aminobutyric acid (GABA), the main inhibitory neurotransmitter in the brain (a chemical that prevents brain cells from firing), and it works against one of the brain’s excitatory neurotransmitters (chemicals that make the cells fire).
Topamax (topiramate) is approved by government regulatory agencies as monotherapy and adjunctive (add-on) therapy for many types of seizures in both adults and children. These include partial seizures (with and without secondary generalization), primary generalized tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome.
In a number of randomized, controlled clinical trials in the 1990s, Topamax was significantly more effective than a placebo as add-on therapy for people with frequent partial seizures. In reports combining several such studies, about 44% of the people who took Topamax reduced their seizure frequency by half or more, compared to about 12% of those who added a placebo. The rate of unwanted side effects was rather high, but many of these people were given higher doses than are usually given now, with more rapid dose increases.
Topamax has the advantage of providing good control of both primary generalized tonic-clonic seizures and partial-onset seizures. In an add-on study that added Topamax or a placebo to other medications, the rate of primary generalized tonic-clonic seizures was reduced by at least half in 56% of those who took Topamax, versus 20% of those who added a placebo. Other types of generalized seizures were similarly reduced in these people.
Children with Lennox-Gastaut syndrome have various types of difficult-to-control seizures, including tonic and atonic seizures with stiffening or falling. When Topamax was added to previous medication, the frequency of major seizures was reduced by at least half for 33% of these children. Only 8% of those who added a placebo had a similar improvement.
Most people who take Topamax (topiramate) have little or no problem with side effects. Those with problems most often complain of:
fatigue or drowsiness
difficulty with concentration
difficulty finding the right word (word retrieval)
confusion
dizziness
unsteadiness
a feeling of pins and needles, usually in the tips of the fingers and toes
loss of appetite and weight loss
Most of these problems are mild to moderate. Many of them were more common when higher doses of Topamax were taken.
The side effect of decreased appetite and weight loss is now a focus of research on Topamax. Data show that at least 5-10% of patients will lose weight, and therefore it is sometimes used in combination with Depakote (valproate), Neurontin (gabapentin), or Tegretol (carbamazepine), which can cause weight gain in some patients. Weight loss can be a problem, however, especially in children and those who are already thin.
Some other side effects mentioned even less often were
nervousness
depression
difficulty with memory
If you notice problems like any of these while you are taking Topamax, it's probably a good idea to discuss them with your doctor or nurse. A few people do experience psychiatric disorders when they take Topamax. You shouldn't stop taking Topamax or any other seizure medicine without your doctor's advice
Be sure to read about the serious side effects of Topamax. Even though very few people experience serious problems, everyone who takes Topamax should be aware of them.
A small percentage of people who take Topamax develop a skin rash within the first few weeks of taking it. If this happens, tell the doctor or nurse right away, to be sure that it's not the beginning of a serious problem. It's rare for the rash to be serious, but don't ignore it. It's often necessary to switch to a different seizure medicine.
Pregnancy Category C. This indicates that caution is advised, but the benefits of the medication may outweigh the potential risks. There have been no well-controlled studies in women, but studies in animals have shown some harm to the fetus.
The babies of women taking seizure medicines in general have a greater than usual number of major birth defects like cleft lip, cleft palate, and heart malformations. Defects like these occur in 2-3% of all pregnancies but affect 4-7% of the babies of women taking seizure medicines. Whether this is also true for Topamax is not yet known.
In the United States, Topamax was approved by the Food and Drug Administration (FDA) in 1996 to treat adults with partial-onset seizures. In 1999 it was approved as an "add-on" treatment for children with partial-onset seizures and for primary, generalized tonic-clonic seizures. In 2001 it was approved for use in Lennox-Gastaut syndrome in children and adults.
Topamax is used to treat a broad range of seizure disorders. It can be used alone or with other seizure medicines to control:
partial-onset seizures in adults and children ages 2-16 years
primary, generalized tonic-clonic seizures in adults and children ages 2-16 years
seizures associated with Lennox-Gastaut syndrome in people 2 years of age and older
Topamax is approved by the Food and Drug Administration (FDA) as initial monotherapy for patients 10 years of age and older with partial-onset or primary generalized tonic-clonic seizures.
Topamax is also effective for other childhood epilepsies.
Topamax helps prevent brain cells from working as fast as a seizure requires them to. In this way, seizures can be stopped when they are just beginning.
Topamax has other effects, too. It enhances the activity of gamma aminobutyric acid (GABA), the main inhibitory neurotransmitter in the brain (a chemical that prevents brain cells from firing), and it works against one of the brain’s excitatory neurotransmitters (chemicals that make the cells fire).
Topamax (topiramate) is approved by government regulatory agencies as monotherapy and adjunctive (add-on) therapy for many types of seizures in both adults and children. These include partial seizures (with and without secondary generalization), primary generalized tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome.
In a number of randomized, controlled clinical trials in the 1990s, Topamax was significantly more effective than a placebo as add-on therapy for people with frequent partial seizures. In reports combining several such studies, about 44% of the people who took Topamax reduced their seizure frequency by half or more, compared to about 12% of those who added a placebo. The rate of unwanted side effects was rather high, but many of these people were given higher doses than are usually given now, with more rapid dose increases.
Topamax has the advantage of providing good control of both primary generalized tonic-clonic seizures and partial-onset seizures. In an add-on study that added Topamax or a placebo to other medications, the rate of primary generalized tonic-clonic seizures was reduced by at least half in 56% of those who took Topamax, versus 20% of those who added a placebo. Other types of generalized seizures were similarly reduced in these people.
Children with Lennox-Gastaut syndrome have various types of difficult-to-control seizures, including tonic and atonic seizures with stiffening or falling. When Topamax was added to previous medication, the frequency of major seizures was reduced by at least half for 33% of these children. Only 8% of those who added a placebo had a similar improvement.
Most people who take Topamax (topiramate) have little or no problem with side effects. Those with problems most often complain of:
fatigue or drowsiness
difficulty with concentration
difficulty finding the right word (word retrieval)
confusion
dizziness
unsteadiness
a feeling of pins and needles, usually in the tips of the fingers and toes
loss of appetite and weight loss
Most of these problems are mild to moderate. Many of them were more common when higher doses of Topamax were taken.
The side effect of decreased appetite and weight loss is now a focus of research on Topamax. Data show that at least 5-10% of patients will lose weight, and therefore it is sometimes used in combination with Depakote (valproate), Neurontin (gabapentin), or Tegretol (carbamazepine), which can cause weight gain in some patients. Weight loss can be a problem, however, especially in children and those who are already thin.
Some other side effects mentioned even less often were
nervousness
depression
difficulty with memory
If you notice problems like any of these while you are taking Topamax, it's probably a good idea to discuss them with your doctor or nurse. A few people do experience psychiatric disorders when they take Topamax. You shouldn't stop taking Topamax or any other seizure medicine without your doctor's advice
Be sure to read about the serious side effects of Topamax. Even though very few people experience serious problems, everyone who takes Topamax should be aware of them.
A small percentage of people who take Topamax develop a skin rash within the first few weeks of taking it. If this happens, tell the doctor or nurse right away, to be sure that it's not the beginning of a serious problem. It's rare for the rash to be serious, but don't ignore it. It's often necessary to switch to a different seizure medicine.
Pregnancy Category C. This indicates that caution is advised, but the benefits of the medication may outweigh the potential risks. There have been no well-controlled studies in women, but studies in animals have shown some harm to the fetus.
The babies of women taking seizure medicines in general have a greater than usual number of major birth defects like cleft lip, cleft palate, and heart malformations. Defects like these occur in 2-3% of all pregnancies but affect 4-7% of the babies of women taking seizure medicines. Whether this is also true for Topamax is not yet known.
