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Topamax is the brand name of topiramate, an anticonvulsant drug used to prevent seizures and reduce the frequency of migraines.
While its exact mechanism of action is unknown, studies suggest Topamax might alter the production or action of neurotransmitters in the brain, suppressing the abnormal activity of the nerves in the brain that cause seizures or preventing the abnormal activity from spreading to other nerves.
Other research has suggested that it might suppress the nerves directly, thereby making them less likely to fire.
The Food and Drug Administration (FDA) approved Topamax to treat seizures in 1996.
In 2004, Topamax received FDA approval for the prevention of migraines.
Manufactured by Janssen Pharmaceuticals, Topamax is now the number-one prescribed medication for migraine prevention in the United States.
It’s used to stop migraine headaches from occurring in those 12 and older.
It cannot be used to treat a headache that has already begun, but it may help to reduce the number of painful migraine.
Topamax and Weight Loss Doctors occasionally prescribe Topamax off-label to control binging and purging and promote weight loss in people with eating disorders such as bulimia nervosa and binge-eating disorder.
The drug is seen as an alternative when first-line therapy with selective serotonin reuptake inhibitors (SSRIs) have failed to achieve results.
It is unclear why Topamax is effective for these uses; however, it is believed that the same properties that enable it to control migraines and seizures also work to inhibit the brain networks that cause food cravings.
Although there have been a number of studies supporting the efficacy of Topamax for weight loss, there remain some concerns regarding its long-term safety.
In addition, the drug has troubling, sometimes serious side effects.
As a result, it is not the first-choice treatment for weight loss in patients with eating disorders.
According to guidelines published by the American Psychiatric Association (APA), Topamax is recommended only when other treatments have been ineffective.
The APA also notes that because it causes weight loss, Topamax may be problematic if you are of normal weight or are under weight.
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