Article: Topamax, migraines and epilepsy.
Introduction: What Topamax is used for?
Topamax is a drug used for the treatment of epilepsy. Aside from being an anti-epileptic, Topamax has also been proven to be an effective treatment for migraines. But primarily, it is approved technically as initial medication for partial onset tonic clonic epileptic or grand mal seizures and even primary, milder generalized seizures. With migraine closely related to epilepsy in terms of cause, administration of Topamax for the two conditions is basically the same in terms of dosage and frequencies.
Topamax should be used strictly for its prescribed indication, that is, for the treatment of epilepsy primarily, and for migraines secondarily. Studies on the drug and the ailments it is used for have shown that results have been more effective and successful when used in dosages of a hundred to two hundred milligrams for migrains, and a lower dose than these when used for epilepsy. In the use of Topamax, it should be noted that if an allergic reaction is produced, its use should be stopped and medical attention sought after. Topamax may be used to complement, if not replace, other treatment regimens that have failed to produce positive effects, but only upon expert medical advice. Moreover, cessation of use needs to be gradual as abrupt withdrawal may cause seizures.
How it works?
Topamax controls mild epileptic attacks or partial seizures and the more severe convulsions of the tonic, clonic type more commonly called grand mal seizures. As a complementary drug, it is added to a probably existing medication or regimen when such existing medication is proving to be only partially effective in controlling seizures or attacks. It works as a neuronal stabilizer (or anticonvulsant) and as such is also prophylactically used for migraine under strict physician supervision.
It works at slow titration or dose working towards therapeutic dose. A patient may, at doctor's advice, start on a lower dose, say 15 milligrams per day, and slowly build up the dose for more effectiveness. Note, however, that in the use of Topamax, the lowering of bicarbonate levels may increase acidity in the blood or produce a condition called metabolic acidosis. Aside from this, other side effects may occur which should be duly relayed to a physician.
For migraines and epilepsy
Migraines are neurological conditions characterized by severe bouts of headaches of varying severity and frequency, lasting from several hours to days even. The attack is usually accompanied by other difficulties like stomach upset, nausea, vomiting, photophobia (or bright-light sensitivity) and noise sensitivity. A headache typically attributed to migraine is usually a throbbing headache that can increase in severity and can be aggravated by any other physical activity. The pain will peak at times, then subside gradually. To address migraine, three treatment stages or levels may be taken into consideration. First is the avoidance of triggers or the factors that contribute or produce the migraine. Next is symptomatic control or the development of coping mechanisms during bouts of migraine.
Topamax topiramate as an anticonvulsant may be introduced to act as preventive medication for migraine. Taken on a daily basis, spanning a few weeks, the frequency will determine the extent of effectiveness of the drug. This must be done under a neurologist’s supervision ideally. Prescription topiramate as anticonvulsant has been proven in studies and controlled trials to be more effective in reducing the frequency of migraine attacks. As a preventive drug, Topamax may not be used after migraine has already started. In such instance, medical attention is required to determine appropriate medication.
On the other hand, epilepsy is a neurological disorder that is chronic and marked by recurring, oftentimes unprovoked, seizures. The seizures result from excessive or abnormal brain neuron activity. Epilepsy may be a group of conditions or syndromes that involve maybe different symptoms but resulting from abnormal activity of neurons in the brain. Treating epilepsy may be a single or combined regimen of medication and therapy and special diets. In some cases, neuro-surgical operations are done depending on the severity of the epileptic attacks.
While it is procedural for the general epileptic seizure of the tonic-clonic type to ensure safety of the patient and prevent him from injuring himself by stabilizing his position, moving him away from sharp edges or corners, and generally avoiding asphyxiation, medication will be very helpful when administered after proper diagnosis and with close medical supervision. Pharmacological treatment involves medications that are taken regularly to address the seizures, prevent or reduce their occurrence. Different types of drugs may be used to prevent seizures, one of them being the topiramate Topamax. Topamax has been cleared for initial monotherapy use for epileptic patients 10 years or older. It may be a complementary or add-on drug for some cases of epileptic seizures whether tonic-clonic or partial onset.
Anticonvulsants in general
Anticonvulsants are medications of varied or diverse types that all belong to a group specifically prescribed for epileptic seizures. Also called anti-epileptics, anticonvulsants are sometimes used also for bipolar disorder because these anticonvulsants also help in stabilizing moods. An anticonvulsant basically suppresses or controls the rapid firing in the brain of neurons; this neuron firing causes or precipitates a seizure. How? The anticonvulsant prevents the spread of the seizure in and avoids damage to the brain. Some medications and/or substances that may fall under the umbrella of anticonvulsants include barbiturates, benzodiazepines, bromides, carbamates, carboxamides, aldehydes, aromatic alcohols, fatty acids, fructose derivatives, hydantoins, GABA analogs, oxazolidinehiones, propionates, pyrimidinediones, pyrrolidines, succinimides, sulfonamides, triazines, ureas, valproylamides or valproate derivatives.
These anticonvulsants work at different levels but mostly they act as controllers to influence certain central nervous system functions. For example, barbiturates act as depressants and may cause sedation. Phenobarbital and other barbiturates may be classified as anticonvulsants, being one of the first anticonvulsants in the early 1900s.
Then again, look at benzodiazepines. These drugs have anticonvulsive properties, aside from their hypnotic and muscle relaxant properties. Some of them like Clobazam, Clonazepam, Clorazepate, Diazepam, Midazolam, and Lorazepam are used as anti-epileptics.
Bromides on the other hand are among the earliest treatments for epilepsy as an anti-convulsant. After the onset of Phenobarbitals which became more popular, bromides retained their more widespread use in veterinary medicine.
Other anticonvulsants as earlier mentioned are further speficied as follows. Carboxamides are available in generic formulations. Topiramate is included under the class of fructose derivatives.
Anticonvulsants, like other drugs, may have mild to severe side effects including but not limited to sleepiness or drowsiness, nervousness, fatigue, lethargy, speech disorder, psychomotor slowing, vision distortion, memory problems, tingling in the extremities, loss of appetite. Should any side effect become persistent or especially bothersome, it must be referred for doctor's attention. In addition, there may be other risks that can be associated to anticonvulsants like lowered blood bicarbonate levels (causing metabolic acidosis), hyperventilation, irregular heartbeats, changing alertness levels, possible kidney or bone disease. Others include fever, confusion, breathing difficulty, and even glaucoma at times. Again, at the onset or when they become bothersome, these side effects or symptoms must be relayed to the doctor immediately.
Generic and branded Topamax side effects -- a comparison
Some side effects attributed to the use of branded Topamax include tingling in the extremities, appetite loss, over-fatigue or extreme tiredness, nausea and vomiting, diarrhea or constipation, loss or changes in sense of taste, and even weight loss. Where generic Topamax included herbal ingredients, the side effects were less marked if not non-existent at all.