Topiramate: Uses, Precautions, Presentation, Differences, Interactions and Dosage

It is distinguished from all other drugs used to treat seizures or mood disorders because it does not share the same chemical composition.

Topiramate is often sold under the Topamax brand. Medical researchers currently do not know how Topiramate works.

What uses does it have?

It is used alone or with other medications to prevent and control seizures ( epilepsy ). This medicine is also used to avoid migraine headaches and decrease how often you get them.

Topiramate will not treat a migraine once it occurs. If you have a migraine headache, treat it as directed by your doctor (for example, taking pain medication or lying in a dark room).

It is known as an anticonvulsant or antiepileptic medication.


When taking it:

  • Take this medicine orally with or without food, as directed by your doctor, usually twice daily.
  • You can swallow this whole medicine, or you can open the capsule and sprinkle the contents in a teaspoon of soft foods (such as applesauce or yogurt). Swallow the drug/food mixture immediately.
  • Do not chew the mixture.
  • Do not prepare the mixture ahead of time for later use.
  • After swallowing the mixture, drink a little liquid to make sure you eat all the medication.
  • To prevent the formation of kidney stones, drink plenty of fluids while taking this medication unless your doctor tells you otherwise.
  • The dose is based on your medical condition and response to treatment.
  • For children, the dosage is also based on weight.
  • Your doctor will gradually increase your dose to reduce your risk of side effects.

For some conditions, you can start treatment with Topiramate once a day at bedtime and slowly increase your dose to twice a day. It may take several weeks or months to reach the best amount for you and get the full benefit of this medication.


Take this medication regularly to get the most benefit from it.

Tell your doctor if your condition persists or gets worse.

Does Topiramate have a generic presentation?

The manufacturer still has patent protection on the drug, so there is not yet a generic version available.

Differences with other stabilizers

Two things distinguish it from other drugs in this class. First, doctors and psychiatrists sometimes prescribe it when other medications that stabilize mood are not adequate for a patient.

Second, the side effects that patients may experience are pretty different in Topiramate compared to other mood stabilizers.

For fast cycles or mixed bipolar states, there are cases where Topiramate is effective when these other two medications are not.

In what disorders have you been most successful in your application so far?

The lack of research on Topiramate makes it challenging to know which disorders will respond best to the drug.

To date, there is not enough psychiatric research to make specific recommendations. In the field, professionals have successfully prescribed Topiramate to people with bipolar disorders who have resisted other forms of treatment.

The most effective use seems to be the case of patients whose use of Lamotrigine has induced mania.

Some psychiatrists have reported using Topiramate to help alleviate the symptoms of PTSD and the side effects related to eating that may be generated by other psychiatric medications.

Can Topiramate treat episodes of depression, mania, and mixed states?

While the first use of Topiramate was for treating mania, depression, or mixed states resistant to other drugs, its effectiveness in preventing those conditions has not yet been proven.

There have been no research studies that put patients on Topiramate for a long time and evaluated whether the likelihood of these episodes decreased.


There are no known interactions between Topiramate and lithium. However, Carbamazepine can reduce the blood plasma level of Topiramate by 50 percent, and Valproate can reduce it by 15 percent. Topiramate can reduce the level of Valproate in blood plasma by 10 percent.

So far, there are no known interactions between patients taking Topiramate and Lamotrigine or Gabapentin.


The final doses of Topiramate vary widely depending on the target disorder, the patient, and whether the patient is taking other medications at the same time or not.

The most common doses fall between 50 and 200 mg per day for most therapies, but this may be less for PTSD. Higher final doses may be required, up to 500 mg per day if taken alone. Some patients experience relief with only 25 mg per day.

How long does it take until the patient feels the effects of Topiramate?

This also varies significantly depending on the individual.

Some feel the effects in a matter of days, while others need up to a month before feeling any difference.