Topiramate is primarily used as a medication to treat epilepsy and to help prevent migraine headaches. In epilepsy, it works by calming overactive nerves in the body to prevent and control seizures[1]. Topiramate is approved as initial monotherapy for focal-onset or primary generalized tonic-clonic seizures in patients 2 years and older, and as adjunctive therapy for focal-onset seizures, primary generalized tonic-clonic seizures, or seizures associated with Lennox-Gastaut syndrome[4]. It is also prescribed as a preventive treatment for migraines (but not for acute migraine attacks)[5].
Topiramate is considered a broad-spectrum antiepileptic drug, effective for several types of partial-onset and generalized-onset seizures in both adults and children[2]. It can be used alone (monotherapy) or in combination with other medicines (adjunctive therapy) depending on the specific type of seizure or syndrome being treated[3].
In addition to its approved uses, topiramate is sometimes used off-label as adjunct therapy for weight management and mood disorders, although these uses should always be guided by a healthcare professional[3].