Topiramate

Antiepileptic drug of unusual structure, is a derivative of fructose. It is not effective as an antimanic or antidepressant for bipolar disorder. Studies are also being conducted on its use in post-traumatic stress, alcoholism, overeating, headaches of various origins and neuropathy.

Trade names: Maxotopyr, Topamax, Topsaever, Toreal, Topaleptsin, Epimax, Epitope.

It is included in the list of vital and essential medicines.

The Food and Drug Administration approved the use of topiramate for the prevention of migraine, and also for use in combination with phentermine for weight loss.

Antiepileptic drug. Refers to the class of sulfate-substituted monosaccharides. Antiepileptic activity of the drug is due to a number of its properties. Topiramate reduces the frequency of occurrence of action potentials that are characteristic of a neuron in a state of persistent depolarization, which indicates the dependence of the blocking action of the drug on the sodium channels on the state of the neuron. Topiramate potentiates GABA activity in some of the subtypes of GABA receptors (including GABAA receptors), and also modulates the activity of the GABAA receptors themselves, inhibits kainate activation of the sensitivity of kainate / AMPK receptors to glutamate, does not affect the activity of N-methyl-D- aspartate for NMDA receptors. These drug effects are dose-dependent with a plasma topiramate concentration of 1 μM to 200 μM, with minimal activity ranging from 1 μM to 10 μM. In addition, topiramate inhibits the activity of certain isoenzymes of carbonic anhydrase, but this effect in the topiramate is weaker than that of acetazolamide and, apparently, is not the main antiepileptic activity of topiramate.

Indications:

- partial or generalized tonic-clonic seizures in adults and children over 2 years of age, including those with newly diagnosed epilepsy (either as monotherapy or in combination with other anticonvulsants);
- Seizures associated with Lennox-Gastaut syndrome in adults and children older than 2 years (as part of complex therapy).
- Prevention of migraine attacks in adults. Ics

Side effect:

From the side of the central nervous system and peripheral nervous system: nervousness, dizziness, headache, speech and vision disorders, diplopia, nystagmus, anorexia, psychomotor retardation, ataxia, fatigue, impaired concentration, confusion, paresthesia, drowsiness, thinking disorder, depression; In addition, in children - personality disorders, increased salivation, hyperkinesia; rarely - perversion of taste, arousal, cognitive disorders, emotional lability, abnormal gait, apathy, psychotic symptoms, aggressive reactions; very rarely - suicidal thoughts, in addition to children - hallucinations.

The drug is approved for use in children older than 2 years. Influence on the ability to drive vehicles and manage mechanisms. Caution should be given to patients who are engaged in potentially dangerous activities that require increased attention and speed of psychomotor reactions, since the drug may cause drowsiness, dizziness.

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