International Journal of
MediPharm Research

Topiramate is a new antiepileptic drug (AED) that has been approved worldwide (in more than 80 countries) for the treatment of various kinds of epilepsy. It is currently being evaluated for its effect in various neurological and psychiatric disorders. Topiramate is used alone or with other medications to prevent and control seizures (epilepsy). This medication is also used to prevent migraine headaches and decrease how often you get them. The present review includes all available information like pharmacokinetics, pharmacological action and side effects. Moreover sometimes it is necessary to monitor the therapeutic concentration of Topiramate. The pharmacokinetics of topiramate are characterised by linear pharmacokinetics over the dose range 100-800 mg, low oral clearance (22-36 mL/min), which, in immunotherapy, is predominantly through renal excretion (renal clearance 10-20 mL/min), and a long half-life (19-25 hours), which is reduced when co administered with inducing AEDs such as phenytoin, phenobarbital and carbamazepine. This paper provides a critical review of the pharmacokinetic interactions of topiramate with old and new AEDs, an oral contraceptive, and the CNS-active drugs lithium, haloperidol, amitriptyline, risperidone, sumatriptan, propranolol and dihydroergotamine. The results of many of these drug interaction studies with topiramate have not been published before, and are presented and discussed for the first time in this article. Keywords: antiepileptic drug, bipolar disorder, epilepsy, migraine, obesity, seizures, substance abuse, topiramate, weight loss.