Topiramate

Summary

Topiramate is an antiepileptic drug that works by increasing GABA-A signaling and blocking sodium channels in the brain. Clinically, it’s a broad-spectrum antiepileptic drug used to treat both generalized and focal seizures. It’s also commonly used to prevent migraines. Side effects include sedation, mood disturbances, dizziness, weight loss, narrow-angle glaucoma, kidney stones, and paresthesia.

Key Points

• Topiramate
  • Mechanism
    • Blocks Na+ channels
      • Blocking of sodium ion influx inhibitors depolarization of neuron, inhibiting firing of action potentials
    • Activates GABA-A receptors
      • Acts as an agonist and may also increase GABA concentrations in the brain
  • Clinical Use
    • Treats seizures (antiepileptic)
      • Broad-spectrum
        • Treats focal (partial) seizures
        • Treats generalized (tonic-clonic) seizures
    • Treats migraine headache (prophylaxis)
  • Side Effects
    • Sedation
    • Dizziness
    • Mood disturbance (e.g. depression)
    • Weight loss
    • Paresthesia
    • Kidney stones
    • Narrow angle (angle-closure) glaucoma