General Information: Topamax is a newer anticonvulsant drug. Topamax is used in conjunction with other antiepileptic drugs in children with difficult to control partial onset seizures.

Formulations: Topamax is available in the following formulations:

• 25 mg tablet
• 100 mg tablet
• 200 mg tablet

Dosage: The usual starting dosage of Topamax is 1 mg/kilogram of body weight per day. In order to minimize side effects of sleepiness, dizziness and incoordination the dosage is slowly increased each week, until your neurologist determines your child has reached a therapeutic dose. Topamax is taken two to three times per day and can be taken with or without food.

Therapeutic Drug Levels: The value of monitoring blood levels of Topamax is not yet established.

Side Effects: The most common side effects of Topamax include sleepiness and fatigue. Other rare side effects include dizziness,in coordination, confusion, memory problems, psychomotor slowing, difficulties with concentration, and speech and language (word finding problems) and mood problems. In studies these symptoms usually occur early on with the treatment, and most patients' symptoms resolve by 8 weeks.

Kidney stones and weight loss have also occurred. Plenty of fluid intake is recommended to reduce the risk of stone formation. Another side effect that adults have experienced is numbness or tingling of the fingers and toes. This usually decreases with time or with a dosage reduction.

Common Labs: While no special laboratory monitoring is necessary during Topamax therapy, your child will likely be taking other antiepileptic drugs and may require some monitoring of liver enzymes and blood cell counts periodically.

Drug Interactions: Topamax has minimal interaction with other antiepileptic drugs. Inform your neurologist if your child is taking any other medications. Your pharmacist can often tell you if there are any known drug interactions between the medications your child is taking.

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