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No Prescription
Topamax decreases the ability of a neurotransmitter called glutamate to excite the nerve cells. It does this by blocking glutamate receptors.
Topamax is an antiepileptic drug, prescribed to control both the mild attacks known as partial seizures and the severe tonic-clonic convulsions known as grand mal seizures. It is typically added to the treatment regimen when other drugs fail to fully control a patient's attacks.
Topamax is prescribed as an add-on treatment for adults and children over two years of age whose epilepsy has not been well controlled by other antiepileptic drugs. It can be prescribed as a single treatment for adults and children over six years of age who have newly diagnosed epilepsy.
Topamax is prescribed by specialists to prevent migraine headaches in adults, for example, for those who have three or more migraine attacks per month, or frequent migraines that significantly interfere with daily routine. It is not fully understood how topiramate works to prevent migraines. Topamax has to be taken continuously to prevent migraines. It is not intended for treating individual migraine attacks.
Topamax is prescribed for the prevention of migraine headaches (also known as prophylactic treatment). However, due to a lack of studies, it's not known whether Topamax can treat acute migraine attacks.
Topamax prevents sodium from entering the nerve cells when they begin to fire rapid and repetitive electrical signals. A build up of sodium in the nerve cells is necessary for the electrical signal to build up and be passed on. Topiramate therefore prevents the excessive electrical activity that causes fits.
Topamax tablets and sprinkle capsules contain the active ingredient topiramate, which is a drug that is prescribed to treat epilepsy.
Topamax works in three ways to prevent epileptic fits. Firstly, it enhances the activity of a neurotransmitter called GABA in the brain. Neurotransmitters are chemicals that are stored in nerve cells and are involved in transmitting messages between the nerve cells. GABA is a neurotransmitter that acts as a natural calming agent. It keeps the nerve activity in the brain in balance. As topiramate enhances the action of GABA, it helps calm the nerve activity in the brain.
All these actions calm the nerve cells and stabilise the electrical nerve activity in the brain. This helps prevent fits and maintain normal brain function.
The brain and nerves are made up of many nerve cells that communicate with each other through electrical signals. These signals must be carefully regulated for the brain and nerves to function properly. When abnormally rapid and repetitive electrical signals are released in the brain, the brain becomes over-stimulated and normal function is disturbed. This results in fits or seizures.
Topamax is prescribed for the treatment of:
- Generalised tonic-clonic seizures;
- Partial seizures;
- Prevention of migraine in adults;
- Type of severe childhood epilepsy;
Side Effects
Topamax side effects that you should report to your health care professional or doctor as soon as possible:
- Abdominal pain;
- Abnormal coordination;
- Abnormal vision;
- Agitation;
- Alteration in taste;
- Anxiety;
- Appetite loss;
- Back pain;
- Behaviour problems in children;
- Breast pain;
- Chest pain;
- Concentration or memory difficulties;
- Confusion;
- Constipation;
- Decreased appetite and weight loss;
- Decreased sense of touch;
- Depression;
- Difficulty sleeping;
- Difficulty with concentration;
- Difficulty with memory;
- Dizziness;
- Double vision;
- Drowsiness;
- Fatigue;
- Fatigue;
- Flu-like symptoms;
- Headache;
- Increased acid levels in the blood;
- Indigestion;
- Language problems;
- Leg pain;
- Loss of coordination;
- Menstrual problems;
- Mood problems;
- Nausea;
- Nervousness;
- Nose inflammation;
- Pins and needles sensation;
- Rash;
- Shaky movements and unsteady walk;
- Sinusitis;
- Slowing of movements;
- Sore throat;
- Speech disturbances;
- Speech problems;
- Tingling or burning sensations;
- Tremors;
- Visual disturbances;
- Weakness or loss of strength;
- Weakness;
- Weight loss;
In children, the more common side effects are:
- Weight loss;
- Viral infection;
- Urinary incontinence;
- Speech problems;
- Rash;
- Pneumonia;
- Nosebleed;
- Nervousness;
- Nausea;
- Loss of coordination;
- Loss of appetite;
- Injury;
- Increased saliva;
- Increased muscle movement;
- Fatigue;
- Drowsiness;
- Dizziness;
- Difficulty with memory;
- Difficulty sleeping;
- Difficulty concentrating;
- Constipation;
- Confusion;
- Behavior problems;
- Aggressiveness;
- Abnormal gait;
Topamax has been known to cause a number of very rare side effects in adults and children (typically striking less than one person in a hundred). If you develop any unfamiliar problems while taking Topamax, report them to your doctor.
Other, less common side effects in children include allergic reaction, digestive inflammation, increased thirst, skin disorders, slowing of movement, vaginal discharge, vision disorders, and weakened reflexes.
Dosage
ADULTS
For Prevention of Migraine Headaches
Your doctor will increase the dose slowly over 4 weeks.
The recommended total daily dose is 100 mg a day, taken in two divided doses.
The usual regimen is as follows:
- Week 1: no morning dose; take 25 mg at night;
- Week 2: take 25 mg in the morning and again at night;
- Week 3: take 25 mg in the morning and 50 mg at night;
- Week 4: take 50 mg in the morning and again at night;
For Seizures
The daily dosage is then increased each week until, by the eighth week, the patient is taking 200 mg twice a day.
Topamax therapy usually begins with a dose of 50 mg once daily during the first week.
If you are taking Dilantin or Tegretol, the dosage of Topamax may need adjustment.
DOSAGE ADJUSTMENT
For people with poor kidney function, the dosage is usually cut in half.
Likewise, the doctor may adjust your dosage if you have liver problems.
On the other hand, those undergoing hemodialysis may need a supplemental dose.
CHILDREN
The usual daily dose for children 2 to 16 years of age is 5 to 9 mg for every 2.2 pounds of body weight, divided into two doses. Topamax therapy usually begins with a dose of 25 mg (or less) once daily during the first week. The daily dosage is then increased each week until the doctor is satisfied with the patient's response.
It may take eight weeks to reach the ideal dose.
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