Topiramat vikt
Kvinnor i fertil ålder. Topiramate , sold under the brand name Topamax among others, is a medication used to treat epilepsy and prevent migraines.
Topiramate (oral route)
Common side effects include tingling , feeling tired, loss of appetite , abdominal pain, weight loss, [ 11 ] and decreased cognitive function such as trouble concentrating. Topiramate is considered "probably compatible" with lactation and is not contraindicated in breastfeeding, though monitoring of the infant for diarrhea or poor weight gain may be considered. Topiramate was approved for medical use in the United States in Topiramate is used to treat epilepsy in children and adults, and it was originally used as an anticonvulsant.
It is most frequently prescribed for the prevention of migraines [ 19 ] as it decreases the frequency of attacks. A review found topiramate of no use in chronic low back pain. One common off-label use for topiramate is in the treatment of bipolar disorder. Topiramate has been used as a treatment for alcoholism. Veterans Affairs and Department of Defense guidelines on substance use disorders list topiramate as a "strong for" in its recommendations for alcohol use disorder.
Other uses include treatment of obesity, [ 31 ] [ 32 ] binge eating disorder , [ 33 ] and off-setting weight gain induced by taking antipsychotic medications. Adverse effects by incidence: [ 40 ] [ 41 ] [ 42 ] [ 43 ]. Rarely, the inhibition of carbonic anhydrase may be strong enough to cause metabolic acidosis of clinical importance. The U. Food and Drug Administration FDA has notified prescribers that topiramate can cause acute myopia and secondary angle closure glaucoma in a small subset of people who take topiramate regularly.
Discontinuation of topiramate may halt the progression of the ocular damage and may reverse the visual impairment.
Preliminary data suggests that, as with several other anti-epileptic drugs, topiramate carries an increased risk of congenital malformations. Cognitive and word-finding difficulties, as they may occur in some patients, may respond to piracetam. Topiramate has been associated with a statistically significant increase in suicidality , [ 50 ] and "suicidal thoughts or actions" is now listed as one of the possible side effects of the drug "in a very small number of people, about 1 in Symptoms of acute and acute on chronic exposure to topiramate range from asymptomatic to status epilepticus , including in patients with no seizure history.
The topiramate molecule is a sulfamate modified sugar, more specifically, fructose di acetonide , an unusual chemical structure for a pharmaceutical. Topiramate is quickly absorbed after oral use. 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. The remainder is extensively metabolized by hydroxylation , hydrolysis , and glucuronidation.
Several cellular targets have been proposed to be relevant to the therapeutic activity of topiramate. There is evidence that topiramate may alter the activity of its targets by modifying their phosphorylation state instead of by a direct action. Although topiramate does inhibit high-voltage-activated calcium channels, the relevance to clinical activity is uncertain. Effects on specific GABA-A receptor isoforms could also contribute to the antiseizure activity of the drug.
Topiramate selectively inhibits cytosolic type II and membrane associated type IV forms of carbonic anhydrase. The 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. Topiramate inhibits maximal seizure activity in electroconvulsive therapy and in pentylenetetrazol -induced seizures as well as partial and secondarily generalized tonic-clonic seizures in the kindling model, findings predictive of a broad spectrum of activities clinically.
Its action on mitochondrial permeability transition pores has been proposed as a mechanism. While many anticonvulsants have been associated with apoptosis in young animals, animal experiments have found that topiramate is one of the very few anticonvulsants [see: levetiracetam , carbamazepine, lamotrigine ] that do not induce apoptosis in young animals at doses needed to produce an anticonvulsant effect.
Topiramate: 7 things you should know
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 to assist in a medicolegal death investigation. Topiramate was discovered in by Bruce E. Maryanoff and Joseph F. Gardocki during their research work at McNeil Pharmaceuticals. Topiramate is being studied as a potential treatment for post traumatic stress disorder.
There is some evidence for the use of topiramate in the management of cravings related to withdrawal from dextromethorphan. A systematic review of seizure treatment for infants aged 1 to 36 months identified three studies that evaluated the use of topiramate. Though its adverse effects including upper respiratory tract infection and loss of appetite were rarely severe enough for the medication to be discontinued in this age group, its effectiveness in reducing seizures was inconclusive.
The available research suffers from small sample sizes, inconsistent findings, and inadequate comparison groups. Media related to Topiramate at Wikimedia Commons.