Topiramate's 2D structure

Topiramate (brand names: Epiramax, Epiramax, Tamate, Topamax and many others) is an anticonvulsant medicine used in the treatment of epilepsy, obesity (in combination with phentermine)[1] and migraine prevention.[2] It may also be used to treat trigeminal neuralgia.[3] It can also be used to treat substance abuse disorders, like alcoholism, cocaine, nicotine dependence, etc.[4]

Uses with largely negative resultsEdit

It was once used to treat bipolar disorder, off-label, but in 2006 a meta-analysis found it ineffective.[5] Likewise it has been used in the treatment of diabetes-related neuropathic pain, albeit the evidence to support this is generally negative.[6] Likewise, in the treatment of metamfetamine dependence there is some signs that it could potentiate the rewarding effects of the drug.[4]


It is believed to work by inhibiting the activity of AMPA receptors and potentiating GABAA receptors. It also has an effect on sodium and calcium channels.[7][8] It also weakly inhibits carbonic anhydrase.[7] Chemically it is a sulfonamide derivative of fructose.

Reference listEdit

  1. Verrotti, A; Scaparrotta, A; Agostinelli, S; Di Pillo, S; Chiarelli, F; Grosso, S (August 2011). "Topiramate-induced weight loss: a review.". Epilepsy Research 95 (3): 189–99. doi:10.1016/j.eplepsyres.2011.05.014. PMID 21684121.
  2. Joint Formulary Committee (2013). British National Formulary (BNF) (65 ed.). London, UK: Pharmaceutical Press. pp. 267–269. ISBN 978-0-85711-084-8.
  3. Wang, QP; Bai, M (October 2011). "Topiramate versus carbamazepine for the treatment of classical trigeminal neuralgia: a meta-analysis.". CNS Drugs 25 (10): 847–57. doi:10.2165/11595590-000000000-00000. PMID 21936587.
  4. 4.0 4.1 Shinn, AK; Greenfield, SF (May 2010). "Topiramate in the treatment of substance-related disorders: a critical review of the literature.". The Journal of Clinical Psychiatry 71 (5): 634–48. doi:10.4088/JCP.08r04062gry. PMC 3736141. PMID 20361908.
  5. Vasudev, K; Macritchie, K; Geddes, J; Watson, S; Young, A (January 2006). "Topiramate for acute affective episodes in bipolar disorder.". The Cochrane Database of Systematic Reviews (1): CD003384. doi:10.1002/14651858.CD003384.pub2. PMID 16437453.
  6. Wiffen, PJ; Derry, S; Lunn, MP; Moore, RA (August 2013). "Topiramate for neuropathic pain and fibromyalgia in adults.". The Cochrane Database of Systematic Reviews 8: CD008314. doi:10.1002/14651858.CD008314.pub3. PMID 23996081.
  7. 7.0 7.1 Shank, RP; Gardocki, JF; Streeter, AJ; Maryanoff, BE (2000). "An overview of the preclinical aspects of topiramate: pharmacology, pharmacokinetics, and mechanism of action.". Epilepsia. 41 Suppl 1: S3–9. doi:10.1111/j.1528-1157.2000.tb02163.x. PMID 10768292.
  8. White, HS (April 2005). "Molecular pharmacology of topiramate: managing seizures and preventing migraine.". Headache. 45 Suppl 1: S48–56. doi:10.1111/j.1526-4610.2005.4501006.x. PMID 15833090.

External linksEdit

  1. 3D models of topiramate (requires javascript)
  2. ChemSpider
  3. DrugBank
  4. Martindale: The Complete Drug Reference
  5. MedlinePlus
  6. PubChem