Topamax Medication – Mechanism of Action

Topamax medication belongs to a group of drugs that are called anticonvulsants. Drugs from this group are prescribed for the treatment of epilepsy, however, many of them are used for other conditions, such as migraine headaches. Topamax is used to prevent migraines or reduce the frequency with which these appear, the medication does not help to get rid of a headache once it has already occurred. Although the medication has proved to be effective, Topamax mechanism of action for migraine prevention is still not known.

Researchers suggest that the effectiveness of Topamax might be based on its ability to change neurotransmitters in the brain. Nerves produce neurotransmitters and use them for communication with other nerves that are located nearby. By changing the way neurotransmitters act or are produced within the brain, Topamax possibly suppresses the deviating activity of nerves or isolates this deviating activity, not allowing it to spread to other nerves, thus preventing seizures and migraines. According to other studies, Topamax does not change neurotransmitters, but affects the nerves directly.

The effectiveness of Topamax for migraines prevention might not be visible from the very start of the treatment. It is possible that a patient will need several months in order for their body to get used to the medication and reduce the frequency of migraines. Despite the fact that Topamax mechanism of action for migraine prevention is not fully understood, trials have shown that due to this medication, the period between migraine attacks significantly increases. The frequency of migraines in people who took the lowest Topamax dosage decreased by 25%, while those who were given the highest dose, reported that the attacks decreased by half.

Topamax (Topiramate) is not used exclusively for prevention of migraines and seizures. The medication is also prescribed for other purposes, although its other uses were not approved by the FDA. One of the most common Topamax side effects is weight loss, so it is often prescribed off-label for weight-management purposes. There are several theories on how exactly the medication works to cause weight loss, however, the precise Topamax mechanism of action for weight loss is also not known.

There have been clinical trials, conducted by Ortho-McNeil company, meant to study Topamax weight loss effect, but these were discontinued because of many side effects the patients experienced.

Several theories exist that might explain how Topamax causes weight loss, but none of them has been completely proved yet.
As it states on Topamax website, the drug alters the taste sensation by reducing saliva. Due to these changes in taste sensation, patients no longer receive pleasure from the consumed food, which might result in weight loss.

Topamax weight loss effect might also be explained by possible ability of the medication to lower the levels of leptin in cortisol and, consequently, the level of cortisol itself. High levels of cortisol, the stress hormone, trigger the production of insulin, which, in its turn, increases a person’s appetite. Therefore, cortisol levels can seriously influence the process of weight gain or weight loss.
According to another theory, Topamax (Topiramate) can affect blood glucose levels and insulin production. This theory is endorsed by the American Diabetes Association and it states that weight loss can be triggered by ketosis. The body loses weight like it would do on a low-carbohydrate diet – it does not use food as its main source of fuel, but uses the fat stores to transform them into energy.

All these theories are different and they only explain the possible Topamax mechanism of action for weight loss. However, all researchers agree that a satisfactory weight loss effect of Topamax cannot be achieved if a person does not stick to a low-calorie diet and does not increase their daily physical activity.

Topamax dosage is usually determined individually, for each particular case. A healthcare professional, while determining the necessary dose of the drug, should take factors such as the nature of a person’s medical condition, their weight, age, and lifestyle into account. The usual starting dose is the lowest one, it is not likely to improve a person’s condition, but is given so that the body would get used to a new drug.

Topamax medication might not be suitable for many categories of people because of numerous side effects it brings about. It should be pointed out that some Topamax side effects may severely harm your health if neglected. You should inform your doctor about any unpleasant or bothering symptoms you might experience.

When your body gets used to the new medication, some Topamax side effects might disappear, and if they are not very bothersome, they do not require immediate medical attention. However, if they last for too long or become more pronounced, do not hesitate and address your doctor for advice.

The following adverse reactions are a reason to contact your doctor immediately:

  • Vision changes, blurred or decreased vision, any discomfort you might experience in your eyes
  • Clumsiness
  • Redness or pain in your eyes
  • Dizziness
  • Confusion
  • Drowsiness
  • Nervousness
  • Sensation of tingling or burning
  • Uncharacteristic tiredness
  • Fever
  • Memory problems
  • Slow mental activity
  • Concentration problems
  • Speech difficulty
  • Fever

Topamax medication can also cause mood swings, aggression, depression, apathy, and suicidal thoughts. Your family members should be aware of these possible Topamax side effects, so in case you or someone from your family notices any of the mentioned changes, you should get medical help immediately.

The use of Topamax for migraines or seizures prevention, weight loss or other medical conditions in pregnant women is not advisable. The medication can seriously affect the health of the unborn baby.
Using Topamax and alcohol might be extremely dangerous as this combination can lead to sleepiness, dizziness, slow thinking and vision changes. It is not recommended to drive or operate heavy machinery unless you know exactly what your reaction to the medication is.

The list of Topamax side effects is not limited to the ones mentioned here, so before taking this medication, you should speak to your doctor about the possible benefits and harm this drug might cause.