Topamax (topiramate) is an anticonvulsant with multiple neurological and psychiatric uses. Here are its FDA-approved indications (U.S.):
✅ FDA-Approved Indications
1. Epilepsy
- Monotherapy:
- For adults and children ≥2 years with partial-onset seizures or primary generalized tonic-clonic seizures.
- Adjunctive therapy:
- For adults and children ≥2 years with:
- Partial-onset seizures
- Primary generalized tonic-clonic seizures
- Seizures associated with Lennox–Gastaut syndrome
2. Migraine
- Migraine prophylaxis (prevention) in adults and adolescents ≥12 years.
- Note: It is not used for acute migraine attacks, only prevention.
⚠️ Important Notes
- Not FDA-approved for weight loss alone, but topiramate is a component of Qsymia (phentermine/topiramate), which is FDA-approved for chronic weight management.
- Off-label uses (with varying evidence): bipolar disorder, alcohol use disorder, PTSD, essential tremor, binge eating disorder.
- Adverse effects: cognitive dulling (“Dopamax”), kidney stones, metabolic acidosis, glaucoma, teratogenic risk (oral clefts).
✅ Summary
Topamax is FDA-approved for:
- Epilepsy (monotherapy or adjunct in partial-onset, generalized tonic-clonic, and Lennox–Gastaut seizures).
- Migraine prophylaxis (≥12 years old).
Would you like me to also prepare a chart of Topamax’s off-label psychiatric indications (bipolar, PTSD, substance use, binge eating), with evidence levels, so you can see where it’s being studied/used beyond FDA approvals?
