The diverse approaches in the prescription of topiramate: a narrative review

Abstract

Topiramate is a second generation anticonvulsant medication, non-benzodiazepine, which has wide pharmacological applicability since its mechanism of action involves several binding sites. It is a fructose-1,6-diphosphate analogue that was initially developed for antidiabetic treatment and later used as an anticonvulsant due to its similarity to acetazolamide. However, based on its actions, the effectiveness of the use of topiramate in several therapies beyond which it was designated has been verified, among them we can find, the use of the drug in the treatment of obesity, in bipolar disorders, in the control of use alcohol and other addictions, among others. A bibliographic analysis of studies published from 2015 to 2020 in the electronic databases PubMed, Scielo and Medline was carried out. The aim of this work was to discuss these applications and their real benefits in clinical practice. With all the information collected in the literature, it was found that topiramate has several clinical applications with effectiveness in the treatment of partial and generalized tonic-clonic crises, migraine prophylaxis, chemical dependency disorders and treatment of obesity with due association.