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Topiramate and valproate are
seizure medicines that are typically used to control
seizures in people who have
epilepsy. It is not clear how they work to prevent
These seizure medicines, when they are
taken regularly, may help to prevent migraine headaches.
These medicines can reduce the number
of migraines you get each month by more than half. This happened to about 50
out of 100 people who took these medicines to prevent migraines.1
Common side effects of topiramate
Topiramate has been linked in some people to a potentially
life-threatening condition called metabolic acidosis, which happens when there
is too much acid in the blood. Symptoms include fatigue, lack of appetite, and
rapid breathing (hyperventilation). If left untreated,
metabolic acidosis can lead to death.
In rare cases, topiramate may
cause serious side effects, such as:
Side effects from valproate may include:
Uncommon but potentially life-threatening side effects of
The U.S. Food and Drug Administration
(FDA) has issued a warning on seizure medicines and the risk of suicide and
suicidal thoughts. The FDA does not recommend that people stop using these
medicines. Instead, people who take seizure medicines should be watched
warning signs of suicide. People who take seizure
medicines and who are worried about this side effect should talk to a doctor.
See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)
Women who take seizure medicines
need to talk with their doctors if they are considering becoming pregnant.
Seizure medicines may harm a fetus. Valproate is more likely to cause serious birth defects, especially if it is taken during the first 3 months of pregnancy.
Topiramate may make birth
control pills less effective. A woman who is taking topiramate may need to use
another method of birth control to reduce her chances of becoming pregnant.
If you have had kidney stones, be sure to tell your doctor this
before you take topiramate. Using topiramate may increase your risk of having
kidney stones again.
Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.
Drugs for migraine (2011). Treatment Guidelines From The Medical Letter, 9(102): 7–12.
June 10, 2011
Anne C. Poinier, MD - Internal Medicine & Colin Chalk, MD, CM, FRCPC - Neurology
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North Kansas City Hospital.