Topiramate FAQ

Topiramate is classified as an anticonvulsant drug, originally created to treat certain types of seizures (partial seizures, tonic-clonic seizures, or Lennox-Gastaut syndrome). It is sold in the United States under the brand name Topomax (with no generic version available).

Regulatory approval has only been given for treatment of seizures, though some health care providers prescribe topiramate for the treatment of other conditions such as migraine headaches, PTSD, Axis II mood disorders, eating disorders, and alcohol or nicotine withdrawal symptoms.

When used for treatment related to seizures, topiramate works by affecting neurotransmitters in an individual’s brain. Neurotransmitters, which are naturally-forming chemicals, allow nerves to send signals to each other and, during a seizure, there is abnormal firing of the nerves. Topiramate alters the production or action of the neurotransmitters – in essence calming them down, and thus suppressing the abnormal activity and lessening the chance of seizure for the person taking this medication.

Use of topiramate is not without concern as the list of potential side effects is large. These can include depression, nervousness, unsteadiness, tingling in extremities, poor concentration, speech difficulties, fatigue, difficulty with memory, and appetite suppression resulting in weight loss.

Interest is growing in the off-label uses which include treatment for assisting with weight loss for people with certain eating disorders, and for the reduction in cravings associated with alcohol and nicotine withdrawal.

Generally, topiramate is not likely to be abused when used for its original purpose. However, the risk of abuse grows for people using it for off-label purposes – in particular those related to addiction withdrawal. As with most drugs used for that purpose, the user needs to watch that a tolerance to the drug doesn’t develop. This can lead the person to take more of the drug to feel the same effects. Greater doses due to increased tolerance heightens the chance of their body producing a dependency for the drug and abuse can escalate to an addiction.

Whether you’ve used topiramate yourself or know someone who has, you may have questions about this prescription drug. To learn more, check out our frequently asked questions or call a representative from The Recovery Village who can help get you answers.