[Pharmacy clinics. Medication of the month. Topiramate (Topamax)]

Topiramate is a new antiepileptic drug that has now become available for prescription in Belgium. In vitro and in vivo preclinical studies have indicated that topiramate has several mechanisms of action that may contribute to its anticonvulsivant activity. A broad antiepileptic spectrum could be suspected that has been confirmed on a clinical basis. Topiramate has favorable pharmacokinetic properties: rapid absorption, long half-life and little interaction with other AED. Several meta-analysis have confirmed its efficacy, particularly as adjunctive therapy for partial onset seizures, refractory to other AED. It is actually reimbursed only for these patients but its indications will probably be widened in the future.