Molecular pharmacodynamics, clinical therapeutics, and pharmacokinetics of topiramate

CNS Neurosci Ther. 2008 Summer;14(2):120-42. doi: 10.1111/j.1527-3458.2008.00041.x.

Abstract

Topiramate (TPM; TOPAMAX) is a broad-spectrum antiepileptic drug (AED) that is approved in many world markets for preventing or reducing the frequency of epileptic seizures (as monotherapy or adjunctive therapy), and for the prophylaxis of migraine. TPM, a sulfamate derivative of the naturally occurring sugar D-fructose, possesses several pharmacodynamic properties that may contribute to its clinically useful attributes, and to its observed adverse effects. The sulfamate moiety is essential, but not sufficient, for its pharmacodynamic properties. In this review, we discuss the known pharmacodynamic and pharmacokinetic properties of TPM, as well as its various clinically beneficial and adverse effects.

Publication types

  • Review

MeSH terms

  • Adult
  • Aged
  • Anti-Obesity Agents / pharmacology
  • Anti-Obesity Agents / therapeutic use
  • Anticonvulsants / adverse effects
  • Anticonvulsants / pharmacokinetics
  • Anticonvulsants / pharmacology*
  • Anticonvulsants / therapeutic use*
  • Female
  • Fructose / adverse effects
  • Fructose / analogs & derivatives*
  • Fructose / pharmacokinetics
  • Fructose / pharmacology
  • Fructose / therapeutic use
  • Humans
  • Hypoglycemic Agents / pharmacology
  • Hypoglycemic Agents / therapeutic use
  • Ion Channel Gating / drug effects
  • Migraine Disorders / drug therapy
  • Neuroprotective Agents / pharmacology
  • Neuroprotective Agents / therapeutic use
  • Neurotransmitter Agents / metabolism
  • Pregnancy
  • Receptors, Presynaptic / drug effects
  • Topiramate

Substances

  • Anti-Obesity Agents
  • Anticonvulsants
  • Hypoglycemic Agents
  • Neuroprotective Agents
  • Neurotransmitter Agents
  • Receptors, Presynaptic
  • Topiramate
  • Fructose