TOPIRAMATE
(Topamax)

Indication: Topiramate is used as adjunctive therapy in adults with complex partial seizure disorder.

Possible side effects: When tested in combination with other anticonvulsants, the most common side effects of topiramate were sleepiness, dizziness, poor coordination, slowed functioning, speech disorders, mood problems, depression, nervousness, jerky eye movements and tingling sensations in the hands or feet. There is a slight increase in the risk of kidney stones with topiramate. For this reason, it is important for you to maintain an adequate fluid intake while taking topiramate.

You need to be aware that any changes in your anticonvulsant therapy, there may be an increase in seizure frequency. Also, keep in mind that side effects vary among individuals. If you have any problems with the medication, you should let your doctor know, whether or not it is a problem listed above.

Dosage: Topiramate is available for oral administration in white 25 mg, gold 100 mg, and peach 200 mg tablets. It also comes in 15mg and 25mg "sprinkle" capsules; the sprinkles can be mixed with food. Topiramate can be taken with or without food. The average dose for topiramate is around 400 mg.

Drug interactions: Carbamazepine (Tegretol, Carbatrol) decreases topiramate levels. Phenytoin (Dilantin) decreases topiramate levels while topiramate increases phenytoin concentrations. Both valproic acid and topiramate levels are decreased when used in combination.

Carbonic anhydrase inhibitors like topiramate increase the risk of kidney stones. Drink plenty of fluids. Topiramate in combination with other central nervous system depressants can cause depression or problems with thinking. Other drugs can affect and be affected by Topiramate.

Oral contraception: The efficacy of some birth control pills can be affected by topiramate. In these cases, topiramate can lower the estrogen levels of the birth control pills. This can be remedied by taking a birth control pill with a higher level of estrogen. Check with your doctor.

Blood levels: Blood levels of topiramate are likely to be in the 3-20 mcg/ml range.