Generality
Topiramate is a drug with anticonvulsive activity, this is why it is used in the treatment of epilepsy, as well as in the prophylaxis of migraine attacks. However, topiramate also appears to be a valid aid in keeping body weight under control and to combat addiction to smoking.
Topiramate - Chemical Structure
However, as regards the treatment of smoking, topiramate remains a second choice drug.
Action mechanism
From the chemical point of view, topiramate is a monosaccharide derivative of fructose which also contains a sulfamate group. The mechanism of action with which topiramate carries out its activity has not yet been fully clarified, but it appears that it is capable of activating some types of GABA receptors (or γ-aminobutyric acid, the main inhibitory neurotransmitter present in our organism) and to antagonize the receptors for glutamate (one of the major excitatory neurotransmitters present in our body).
It is believed that the aforementioned activities are in some way involved in controlling the mechanisms underlying nicotine addiction and that they are therefore able to diminish the pleasure and gratification deriving from smoking.
In fact, the studies conducted on the use of topiramate in the treatment of smoking, although they have given positive results, are still too few and, probably, further investigations will be needed.
Side effects
Not much data is available regarding the possible side effects that may occur during a topiramate-based smoking cessation therapy.
However, among the main side effects that topiramate can cause, we recall:
- Depression;
- Seizure crises;
- Anxiety;
- Irritability;
- Mood changes;
- Confusion and disorientation;
- Difficulty concentrating;
- Memory loss;
- Slowness of thought;
- Increased frequency of urination.
Furthermore, topiramate can trigger allergic reactions in sensitive individuals. These reactions can manifest with symptoms such as skin reactions, hives, itching, edema and redness.
dosage
Generally, topiramate is available for oral administration in the form of hard capsules or tablets.
The dosage must be established by the doctor on an individual basis for each patient.
Use during pregnancy and lactation
Because of the potential risks that can be present for the fetus or the child, the use of topiramate by pregnant women and by breastfeeding mothers is not recommended and, in any case, it is always good to ask before doctor's advice.
Contraindications
The use of topiramate is contraindicated in patients with known hypersensitivity to the same topiramate. Furthermore, topiramate is generally contraindicated during pregnancy and lactation.
Finally, it should be remembered that topiramate can interfere with the activity of other types of drugs and can give rise to very dangerous drug interactions. Therefore, it is absolutely necessary to inform your doctor if you are taking - or have recently been taken - drugs of any kind, including non-prescription medicines and herbal products.
