Topiramate and valproate are
seizure medicines that are typically used to control
seizures in people who have
epilepsy. It is not clear how they work to prevent
Why It Is Used
These seizure medicines, when they are
taken regularly, may help to prevent migraine headaches.
How Well It Works
These medicines can reduce the number
of migraines you get each month by more than half. This happened to about 50
out of 100 people who took these medicines to prevent migraines.1
Common side effects of topiramate
A prickling or tingling
sensation in the hands and feet.
Loss of appetite and weight
Inability to concentrate or speak clearly.
Topiramate has been linked in some people to a potentially
life-threatening condition called metabolic acidosis, which happens when there
is too much acid in the blood. Symptoms include fatigue, lack of appetite, and
rapid breathing (hyperventilation). If left untreated,
metabolic acidosis can lead to death.
In rare cases, topiramate may
cause serious side effects, such as:
Headache pain that is different than pain from a migraine
Uncommon but potentially life-threatening side effects of
Inflammation of the
Elevated levels of ammonia in the blood
The U.S. Food and Drug Administration
(FDA) has issued a warning on seizure medicines and the risk of suicide and
suicidal thoughts. The FDA does not recommend that people stop using these
medicines. Instead, people who take seizure medicines should be watched
warning signs of suicide. People who take seizure
medicines and who are worried about this side effect should talk to a doctor.
See Drug Reference for a full list of side effects. (Drug
Reference is not available in all systems.)
What To Think About
Do not use valproate if you are pregnant, breast-feeding, or planning to get pregnant. If you need to use this medicine, talk to your doctor about how you can prevent pregnancy.
Women who use topiramate during pregnancy have a slightly higher chance of having a baby with birth defects. If you are pregnant or planning to get pregnant, you and your doctor must weigh the risks of using this medicine against the risks of not treating your condition.
Topiramate may make birth
control pills less effective. A woman who is taking topiramate may need to use
another method of birth control to reduce her chances of becoming pregnant.
If you have had kidney stones, be sure to tell your doctor this
before you take topiramate. Using topiramate may increase your risk of having
kidney stones again.
Drugs for migraine (2011). Treatment Guidelines From The Medical Letter, 9(102): 7–12.
How this information was developed to help you make better health decisions.