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About Topamax

Topiramate, sometimes known by the brand name of Topamax, is a medication used to treat seizures and convulsions caused by epilepsy and other disorders. Both medications are available in 25, 100, and 200 mg dosages, and are available as both tablets and capsules containing small beads. Topamax is usually prescribed at dosages of 25 to 50 mg, twice a day, to start with, but normally increase to dosages of up to 100 mg to 200 mg a day to manage seizures. The manufacturer recommends that people do not take more than 400 mg a day.

Topamax is prescribed to treat epilepsy, but has also been approved for use for treating Lennox-Gastaut syndrome in children, which can cause seizures and developmental problems. However, its most common use is for the treatment of migraine headaches. Some psychiatrists prescribe Topamax to treat bipolar disorder, and studies are investigating if Topamax could be effective in treating alcoholism, binge eating, post-traumatic stress disorder, and obsessive-compulsive disorder.

The exact way in which Topamax works is not currently known, but it is structurally similar to some sugars, and is absorbed quickly after being taken orally. It may work to prevent seizures by increasing inhibitory activity in the brain through voltage-dependent calcium channels and GABA receptors, and to decrease excitatory activity in the brain by dampening signals at glutamate receptors and through inhibiting certain enzymes.

Topamax has been associated with a wide range of side effects in patients taking this medication:

  • 23.7% of people taking Topamax experienced numbness or tingling in their limbs
  • 17.5% experienced a respiratory tract infection
  • 16.8% experienced diarrhea
  • 15.4% experienced nausea
  • 13.3% experienced loss of appetite
  • 11.2% experienced memory problems, especially among patients taking this medication for bipolar disorder

Unfortunately, some of the side effects associated with Topamax are experienced by newborns if the mother was taking this medication while pregnant. The most common birth defect seen in infants as a result of the mother taking Topamax is cleft lip or cleft palate. In March, 2011, the FDA even issued a warning to health care workers, as well as patients, that the use of Topamax while pregnant can elevate the risk of this type of birth defect occurring.

According to research, the infants of mothers taking Topamax or its generic equivalent during pregnancy have a risk of developing a cleft lip or cleft palate that is 20 times greater than infants whose mothers did not take this medication. Since these birth defects generally develop in the first three months of pregnancy, before many women realize they are pregnant, the FDA felt that it was important to put this warning out to women of child-bearing age.

Cleft lip and cleft palate can result in a split in the lip or hole in the roof of the mouth, and this can impact the child’s ability to receive proper nutrition. In order to correct this defect, multiple operations may sometimes be necessary.

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