Topiramate
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| Trade names | Topamax, Trokendi XR, Qudexy XR |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a697012 |
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| Routes of administration |
Oral |
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| Pharmacokinetic data | |
| Bioavailability | 80% |
| Protein binding | 13–17%; 15–41% |
| Metabolism | Hepatic (20–30%) |
| Biological half-life | 19–25 hours |
| Excretion | Urine (70–80%) |
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| ECHA InfoCard | 100.129.713 |
| Chemical and physical data | |
| Formula | C12H21NO8S |
| Molar mass | 339.363 g/mol |
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Topiramate (brand name Topamax) is an anticonvulsant (antiepilepsy) drug. In late 2012, topiramate was approved by the United States Food and Drug Administration (FDA) in combination with phentermine for weight loss. The drug had previously been used off-label for this purpose. Topiramate was originally produced by Ortho-McNeil Neurologics and Noramco, Inc., both divisions of the Johnson & Johnson Corporation. This medication was discovered in 1979 by Bruce E. Maryanoff and Joseph F. Gardocki during their research work at McNeil Pharmaceuticals.
Topiramate came into commercial use in 1996. Generic versions are available in Canada and these were approved by the FDA in September 2006. Mylan Pharmaceuticals was granted final approval for generic topiramate by the FDA for sale in the United States. The last patent for topiramate in the U.S. was for use in children and expired on February 28, 2009.
Topiramate is used to treat epilepsy in children and adults, and it was originally used as an anticonvulsant. In children, it is indicated for the treatment of Lennox-Gastaut syndrome, a disorder that causes seizures and developmental delay. It is also Food and Drug Administration (FDA) approved for, and most frequently prescribed for, the prevention of migraines. The drug is also used to treat migraines due to the effect it has on the blood vessels in the brain. It has been found to be increasingly effective for migraine sufferers with limited side effects.
Psychiatrists have used topiramate to treat bipolar disorder, although the available evidence does not support its use in any phase of bipolar disorder treatment. A more recent review, published in 2010, suggested a benefit of topiramate in the treatment of symptoms of borderline personality disorder, however the authors note that this was based only on one randomized controlled trial and requires replication. Also the authors noted that the long-term effects have not been studied.
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