How well does Topamax work?

Topamax has been extensively studied to receive approval by the Food and Drug Administration for its use in the United States. Like all prescription medications, Topamax had to be evaluated for how well it works for its intended use in relation to the number and types of side effects. Only you and your doctor can determine together if taking the medication provides enough benefit to outweigh any potential risks.

 

Studies Show that Topamax Works:

  • As a first-line single-drug treatment to prevent some types of seizures in people aged 10 and older
  • In combination with other drugs to prevent certain types of seizures in people aged 2 and older
  • In combination with other drugs to prevent seizures in patients aged 2 and older with Lennox-Gastaut syndrome
  • To prevent migraine headaches in adults. (Topamax is not intended to relieve the pain of a migraine headache once it has started.)

 

Topamax Efficacy for Preventing Migraines in Patients Ages 12 and Older

The effectiveness of Topamax tablets for preventing migraines was proven in 2 studies, each of which involved medium numbers of people. Both studies involved people roughly between the ages of 12 and 70 years. All of the people who were studied had a history of migraine (with or without aura) for at least 6 months. They did not have cluster headaches or basilar, ophthalmoplegic, hemiplegic, or transformed migraine headaches.

In both studies, Topamax dosages of 100 mg/day and 200 mg/day were both significantly better than a placebo (a sugar pill that contains no medicine) at reducing the number of migraines that people had in an average 28 day period.

Topamax Efficacy for Epilepsy When Taken Alone by Patients Ages 10 Years and Older

The effectiveness of Topamax as a treatment for seizures in patients age 10 and older with epilepsy was proven in at least one medium-size study. This study looked at people who had seizures that affected either one half or both halves of the brain. In this study, a Topamax dosage of 400 mg/day was more effective at preventing both types of seizures than was a Topamax dosage of 50 mg/day.

 

Topamax Efficacy for Partial Seizures When Taken with Other Drugs

The effectiveness of taking Topamax along with not more than 2 other medicines to prevent partial seizures in patients with epilepsy was proven in six studies. Partial seizures are seizures that affect only one half of the brain. In these studies, patients were given either a placebo (a sugar pill that contains no medicine) or one of several dosage levels of Topamax (ranging from 200-1000 mg/day) along with their other anti-epilepsy drugs (AEDs). In these studies on the prevention of seizures, adding a Topamax dosage to other AEDs was more effective than adding a placebo to the AEDs.

 

Topamax Efficacy for Partial Seizures When Taken with Other Drugs by Children Ages 2 to 16

The effectiveness of taking Topamax along with other medicines to prevent partial seizures in children with epilepsy was proven in a study of patients aged 2 to 16. Partial seizures are seizures that affect only one half of the brain. In these studies, patients were given either a placebo (a sugar pill that contains no medicine) or one of several dosage levels of Topamax (ranging from 125-400 mg/day) along with up to two other anti-epilepsy drugs (AEDs). Dosages for each child were made based upon their individual needs and body weight. The maximum Topamax dosage was about 6 mg of Topamax per kilogram of body weight per day. In this study on the prevention of partial seizures, adding a Topamax dosage to other AEDs was more effective than adding a placebo to the AEDs.

 

Topamax Efficacy for Tonic-Clonic Seizures When Taken with Other Drugs by Patients Ages 2 and Older

The effectiveness of taking Topamax along with other medicines to prevent tonic-clonic seizures in patients with epilepsy was proven in a study of patients aged 2 and older. Tonic-clonic seizures, formerly known as grand mal seizures, typically include a stiffening of the muscles followed by spasms of the muscles, and a loss of consciousness. The patients in this study were taking up to 2 other types of anti-epileptic drugs when the study began. Topamax dosages ranged from 175-400 mg/day and were determined based upon individual needs and body weight. The maximum Topamax dosage was about 6 mg of Topamax per kilogram of body weight per day. In this study on the prevention of tonic-clonic seizures, adding a Topamax dosage to other AEDs was more effective than adding a placebo to the AEDs.

 

Topamax Efficacy with Lennox-Gastaut Syndrome When Taken with Other Drugs by Patients Ages 2 and Older

The effectiveness of taking Topamax along with other medicines to prevent seizures related to Lennox-Gastaut Syndrome was proven in a study of patients aged 2 and older. Lennox-Gastaut Syndrome is a severe form of epilepsy that starts in early childhood and causes symptoms including frequent seizures of different types, as well as delays in learning and problems interacting with other people. The seizures related to Lennox-Gastaut Syndrome can cause stiffening of the muscles, falling and loss of consciousness, staring spells, or sudden muscle spasms. Patients in this study were taking up to 2 other anti-epileptic drugs (AEDs) in addition to either Topamax or a placebo (a sugar pill that contains no medicine). The maximum Topamax dosage was about 6 mg of Topamax per kilogram of body weight per day. In this study, adding a Topamax dosage to other AEDs was more effective at preventing seizures than was adding a placebo to the patient’s other AEDs.

 

Topamax Use in Children

The safety and effectiveness of Topamax for treating seizures in patients younger than age 2 has not been established. For children older than age 2, Topamax is recommended to be taken along with other anti-epileptic drugs, not by itself. The safety and effectiveness of Topamax in preventing migraines in children has not been established.

Topamax Use in Older Adults

There does not appear to be a difference in safety and effectiveness of Topamax for people over the age of 65. However, there were not very many elderly adults participating in the Topamax studies that have been done. Because patients over the age of 65 may have other health conditions or may be taking other medicines, they should be closely monitored by a doctor when they begin taking a new medicine and when their dosage is increased. Older adults may need to take a lower Topamax dosage if their kidneys are not working properly.

 

Deciding if Topamax is Right for You

Topamax has been used effectively by millions of consumers in the United States. Only a physician can decide if Topamax is right for you, but you should understand the potential benefits and risks of taking this medicine. If you are taking Topamax and have any concerns, be sure to speak with your doctor. Never stop taking any medication without your doctor’s advice.

Written & reviewed by: Lisa Erwin R.Ph. CGP | Last review date: Dec 2010. Click the References Link below for a complete list of references.

Written & reviewed by: Lisa Erwin R.Ph. CGP | Last review date: Dec 2010.
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