[9][10] Serious side effects may include suicide, increased ammonia levels resulting in encephalopathy, and kidney stones.

[23] Topiramate has not been shown to work as a pain medicine in diabetic neuropathy, the only neuropathic condition for which it has been adequately tested.

[25][26][27] A review published in 2010 suggested a benefit of topiramate in the treatment of symptoms of borderline personality disorder; however, the authors noted that this was based only on one randomized controlled trial and requires replication.

[30] Other uses include treatment of obesity[31][32] and binge eating disorder,[33] and off-setting weight gain induced by taking antipsychotic medications.

Preliminary data suggests that, as with several other anti-epileptic drugs, topiramate carries an increased risk of congenital malformations.

[53] Topiramate has been deemed the primary substance that led to fatal overdoses in cases that were complicated by polydrug exposure.

[54] The most common signs of overdose are dilated pupils, somnolence, dizziness, psychomotor agitation, and abnormal, uncoordinated body movements.

Some of the most common are listed below: The topiramate molecule is a sulfamate modified sugar – more specifically, fructose diacetonide, an unusual chemical structure for a pharmaceutical.

It has a half-life of 21 hours and a steady state of the drug is reached in 4 days in patients with normal renal function.

Its action on carbonic anhydrase isoenzymes may contribute to the drug's side effects, including its propensity to cause metabolic acidosis and calcium phosphate kidney stones.

[61] Blood, serum, or plasma topiramate concentrations may be measured using immunoassay or chromatographic methods to monitor therapy, confirm a diagnosis of poisoning in hospitalized patients, or assist in a medicolegal death investigation.

[62][63][64] Topiramate was discovered in 1979 by Bruce E. Maryanoff and Joseph F. Gardocki during their research work at McNeil Pharmaceuticals.

[71] A 2023 systematic review of seizure treatment for infants aged 1 to 36 months identified three studies that evaluated the use of topiramate.