Drugs Prescribed for Bipolar Disorder: Topamax (Topiramate)

Marcia Purse Health Guide
  • Topamax is an anti-seizure drug that's sometimes prescribed as a mood stabilizer to treat bipolar disorder. Topamax - and the generic topiramate - are not FDA-approved for use in bipolar disorder, only for epilepsy and migraines.


    Taking Tegretol (carbamazepine) with Topamax can decrease the concentration of Topamax in your blood by as much as 40%, so be sure to discuss the combination with your doctor regarding this issue if you are taking both. If you are taking Metformin or Lithium, make sure your doctor knows this, as there could be problem interactions with either of those drugs. Of course, all your doctors should know about all medications you are taking.

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    If you have vision changes while taking Topamax, contact your doctor immediately, and make sure to have regular eye exams. Permanent vision loss is possible if symptoms are not detected or treated.


    Use of Topamax during pregnancy carries a higher than normal risk of oral cleft birth defects. Discuss with your doctor whether you should take this drug if you are pregnant or planning to become pregnant. In addition, Topamax may decrease the effectiveness of some birth control, and since it's excreted in breast milk, mothers who want to breast-feed an infant should discuss discontinuing Topamax or not nursing after all.


    The most common side effects are tingling, loss of appetite, weight loss, fatigue, dizziness, sleeplessness, nervousness, change in sense of taste, memory problems, confusion, and difficulty with concentration or attention. These aren't the only possible side effects, so report anything unusual to your doctor as soon as possible.


    Generally, Topamax should be discontinued gradually, but if side effects or other reasons demand a rapid discontinuation, patients should be monitored for possible seizure activity.


    Source: FDA Approval Label for Topamax dated March 4, 2011.

Published On: May 26, 2011