TOPIRAMATE SPINKLE

Anticonvulsant

Brand names: TOPIRAMATE

Oral

Mechanism of Action

12.1 Mechanism of Action The precise mechanisms by which topiramate exerts its anticonvulsant and preventive migraine effects are unknown; however, preclinical studies have revealed four properties that may contribute to topiramate's efficacy for epilepsy and the preventive treatment of migraine. Electrophysiological and biochemical evidence suggests that topiramate, at pharmacologically relevant concentrations, blocks voltage-dependent sodium channels, augments the activity of the neurotransmitter gamma-aminobutyrate at some subtypes of the GABA-A receptor, antagonizes the AMPA/kainate subtype of the glutamate receptor, and inhibits the carbonic anhydrase enzyme, particularly isozymes II and IV.

Indications

adjunctive therapy for the treatment of partial-onset seizures

primary generalized tonic-clonic seizures

Contraindications

• 4 CONTRAINDICATIONS None. None

FDA Warnings

5 WARNINGS AND PRECAUTIONS Acute myopia and secondary angle closure glaucoma: can lead to permanent visual loss; discontinue topiramate as soon as possible( 5
4 ) Suicidal behavior and ideation: antiepileptic drugs increase the risk of suicidal behavior or ideation ( 5
10 ) Serious skin reactions: If SJS or TEN is suspected, discontinue topiramate ( 5
Elevated intraocular pressure of any etiology, if left untreated, can lead to serious sequelae including permanent vision loss

Known Side Effects

10 documented side effects by frequency

Drug Not Working

>10%

Headache

1-10%

Nausea

1-10%

Fatigue

1-10%

Dizziness

1-10%

Depression

1-10%

Diarrhea

1-10%

Vomiting

0.1-1%

Weight Gain

0.1-1%

Tingling/Numbness

0.1-1%

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Compare With

14 available comparisons

Formulations

Dosage Forms

Tablet

Route

Oral