Topiramate (Topamax) is an antiepileptic drug which was approved by FDA for treatment of epilepsy in children and migraine headaches in adults. Topiramate is metabolized by the liver. Clearance decreases with renal failure. Circulating half life is 16 to 24 hours.
Common adverse effects include fatigue, confusion, expressive speech, decreased concentration, mood disorders, paresthesias and weight loss. Serious adverse effects include renal stones, olighydrosis, and glaucoma.
Therapeutic range is 5-20 ug/mL for treatment of epilepsy. Therapeutic drug monitoring is helpful because drug metabolism varies widely from one individual to another.
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