Topamax, the brand name for topiramate, is an anticonvulsant medication. Topamax has specific U.S. Food and Drug Administration-approved indications. It is vital, however, that before use the physician is aware of a patient's entire medical history, including all prescription and over-the-counter medications being taken.
Indications
Topamax is administered alone or in combination for partial onset seizures and primary generalized tonic-clonic seizures. It is also indicated as part of the treatment of seizures in patients with Lennox-Gastaut syndrome. Lennox-Gastaut syndrome is a severe form of epilepsy that typically presents before the age of 4.
Many seizure types are seen with this syndrome, including tonic, atonic and myoclonic. According to MayoClinic.com, Topamax cannot cure epilepsy; it controls seizures as long as the patient takes the medication as directed.
The medication is also used to prevent migraine headaches, but can not relieve pain once the migraine occurs.
Dosing
The dose of Topamax is increased gradually over time. If Topamax is used alone, the starting dose in children older than 10 and adults is 25 mg twice a day. This dose may be increased weekly by 50 to 100 mg per day up to the maximum dose of 200 mg. The dose for children between 2- and 16-years-old is 25 mg or less based on weight and increased by 1 to 3 mg a week.
When Topamax is used with other medications, the usual dose is 25 to 50 mg per day and increased by 25 mg per week with a maximum dosage of 100 to 200 mg per day. The "Drug Information Handbook" states that the initial dose for preventing migraines is 25 mg per day given in the evening. The dose may be increased weekly by 25 mg up to the maximum dose of 50 mg to be taken twice a day.
Administration
Topamax is available as a tablet and sprinkle capsule, which is a capsule filled with small beads of medication. The patient may take the drug without regard to meals. Topamax tablets should not be split, chewed or crushed; the patient should swallow the tablets whole with a full glass of water. PubMed Health explains that the sprinkle capsule may be swallowed whole or opened and sprinkled over food. If the patient decides to open the capsule, he should pour the medication over soft food, such as applesauce, pudding or yogurt.
Discontinuing Therapy
The patient should not stop taking the drug without the approval of a physician. Topamax must be tapered off gradually, which means the dose is decreased over time. If the medication is discontinued abruptly, the patient may experience a severe seizure.
Monitoring
According the "Drug Information Handbook," patients using Topamax should be monitored for frequency of seizures, adequate hydration and electrolyte levels. The patient should also be monitored for signs and symptoms of overdose, such as convulsions, drowsiness, speech disturbance, blurred vision, sluggishness and impaired mental status.
References
- MayoClinic.com: Topiramate
- "Drug Information Handbook"; Charles F. Lacy, Lora L. Armstrong, et al.; 2009
- PubMed Health: Topiramate
