Topiramate (brand names include Topamax, Trokendi, and Qudexy XR) is a prescription medication primarily used to treat epilepsy and prevent migraine headaches. Here's a concise overview:
Key Uses
Epilepsy:
Treats partial-onset seizures and generalized tonic-clonic seizures.
Often used as an adjunct therapy (combined with other anti-seizure medications).
Migraine Prevention:
Helps reduce the frequency and severity of migraines in adults.
Other Off-Label Uses (not FDA-approved but sometimes prescribed):
Bipolar disorder (manic episodes).
Alcohol or opioid use disorders.
Cluster headaches (controversial).
How It Works
Topiramate affects the brain by:
Enhancing GABA (an inhibitory neurotransmitter).
Inhibiting glutamate (an excitatory neurotransmitter).
Blocking sodium channels to stabilize overactive neurons.
Inhibiting carbonic anhydrase (an enzyme linked to side effects).
Dosage & Administration
Typically started at a low dose, gradually increased to minimize side effects.
Available in immediate-release and extended-release forms.
Taken with food or water to reduce stomach upset.
Common Side Effects
Mild: Dizziness, fatigue, weight loss, tingling in hands/feet, cognitive issues (e.g., memory problems, difficulty concentrating).
Serious (rare but urgent):
Angle-closure glaucoma (sudden eye pain, blurred vision—seek immediate help).
Metabolic acidosis (due to carbonic anhydrase inhibition; symptoms include fatigue, loss of appetite).
Kidney stones (increased risk from metabolic acidosis).
Important Considerations
Pregnancy Risk: May harm the fetus; use contraception if on birth control.
Drug Interactions: Avoid alcohol; may interact with hormonal contraceptives (reduced effectiveness).
Tapering Required: Sudden discontinuation can trigger seizures or withdrawal symptoms.
Always follow your healthcare provider’s instructions and report any adverse effects promptly.
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