Topiramate

Topiramate is technically an antiepileptic drug (also known as an anticonvulsant). It works by stabilizing nerve activity in the brain, which helps prevent migraine attacks. Taken consistently, it can help reduce the frequency of migraines.

Be sure to discuss your medical history, current medications, and any concerns with your provider so they can determine whether topiramate is right for you. You should not take topiramate if you have a history of kidney or liver disease, glaucoma, kidney stones, or severe depression. Let your provider know if you are pregnant, plan to become pregnant, or are breastfeeding. Additionally, topiramate may cause your birth control to be less effective. We recommend touching base with your provider to discuss alternatives and/or strategies to prevent pregnancy while using this.

The most common side effects of topiramate are paresthesia (feelings of tingling or numbness), anorexia, weight loss, taste perversion, diarrhea, difficulty with memory, hypoesthesia, and nausea. More serious side effects include metabolic acidosis, kidney stones, decreased sweating leading to hyperthermia, and acute angle-closure glaucoma. If you experience severe side effects, please seek immediate in-person medical care.

It's important to tell your provider if you are taking any other medications, over-the-counter drugs, supplements, or if you have any allergies. If you start using any new medications while taking topiramate, let your provider know. Check with your provider before stopping or starting any of your current medicines. We recommend NOT starting Topiramate if you are using other anti-seizure medications or a carbonic anhydrase inhibitor such as acetazolamide, zonisamide, dorzolamide etc.

Topiramate is a daily medication. It is important to follow your provider’s exact dosing instructions to support migraine prevention. This medication may require titration, meaning your provider will work with you to slowly increase your dose over time.