Topiramate for the treatment of epilepsy and other nervous system disorders.
Initially synthesized as an oral hypoglycemic agent, topiramate was approved for use as an anticonvulsant in 1996. Its broad spectrum efficacy in epilepsy, including as monotherapy and in children, is well established. Topiramate has also been used in the management of nonepileptic neurologic and psychiatric conditions, including migraine prophylaxis (with firmly established efficacy), obesity (with some evidence of long-term maintenance of weight loss), substance dependence, bipolar disorder and neuropathic pain, and it has been investigated as a possible neuroprotective agent. Paresthesias and cognitive side effects are the most common troublesome adverse effects. Recent trends towards lower doses may help achieve the best combination of efficacy and tolerability.
van Passel
Leonie
L
Comprehensive Epilepsy Center, Neurological Institute, Columbia University, Box NI-135, New York, NY 10032, USA. leoniema@msn.com
Arif
Hiba
H
Hirsch
Lawrence J
LJ
D002986:Clinical Trials as Topic; D004361:Drug Tolerance; D064420:Drug-Related Side Effects and Adverse Reactions; D004827:Epilepsy / Q000188:drug therapy*; D005104:Expert Testimony; D005632:Fructose / Q000031:analogs & derivatives* / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D009422:Nervous System Diseases / Q000188:drug therapy*; D018696:Neuroprotective Agents / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D000077236:Topiramate
D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose