eMedExpert Home > Compare Drugs > Topiramate (Topamax)

• Efficacy:
• Epilepsy: Both agents have similar effectiveness for initial treatment of newly diagnosed epilepsy: time to exit, time to first seizure, and the proportion of patients seizure-free during the last 6 months of treatment 2.
  In the open trial comparing monotherapy with topiramate versus carbamazepine the percentage of free seizure patients was greater in topiramate group than carbamazepine 4.
• Side effects and tolerability: Topiramate 100 mg/day is associated with the fewest discontinuations due to adverse events 2.
Most common adverse events associated with topiramate are somnolence, weight loss and with carbamazepine are somnolence, dizziness and seizure discontrol 4.

• Efficacy:
• Epilepsy: Both anticonvulsants have similar effectiveness for initial treatment of newly diagnosed epilepsy: time to exit, time to first seizure, and the proportion of patients seizure-free during the last 6 months of treatment 2.
• Prevention of migraine: Topiramate appears to be equivalent in efficacy and safety to sodium valporate. Both agents cause significant decrease in duration, monthly frequency, and intensity of headache 5.
• Side effects and tolerability: Topiramate 100 mg/day is associated with the fewest discontinuations due to adverse events 2.

Pathological gambling: In the comparison study of the effectiveness of topiramate versus fluvoxamine in the treatment of PG the CGI-improvement (Clinical Global Impression-Improvement) score was significantly better for the topiramate group 3.

The study evaluated the cognitive effects of topiramate and gabapentin. Topiramate impaired cognitive test performance, whereas gabapentin had minimal effects 6.

• Topiramate (Topamax) Medical Facts

• 1. Physicians’ Desk Reference, 59th ed; Thomson PDR: Montvale, NJ; 2005.
• 2. Privitera MD, Brodie MJ, Mattson RH, Chadwick DW, Neto W, Wang S; EPMN 105 Study Group. Topiramate, carbamazepine and valproate monotherapy: double-blind comparison in newly diagnosed epilepsy. Acta Neurol Scand. 2003 Mar;107(3):165-75. PubMed
• 3. Dannon PN, Lowengrub K, Gonopolski Y, Musin E, Kotler M. Topiramate versus fluvoxamine in the treatment of pathological gambling: a randomized, blind-rater comparison study. Clin Neuropharmacol. 2005 Jan-Feb;28(1):6-10. PubMed
• 4. Rese'ndiz-Aparicio JC, Rodri'guez-Rodri'guez E, Contreras-Bernal J, Ceja-Moreno H, Barraga'n-Pe'rez E, Garza-Morales S, Malago'n-Valde'z J, Ortega-Gonza'lez F. A randomised open trial comparing monotherapy with topiramate versus carbamazepine in the treatment of paediatric patients with recently diagnosed epilepsy. Rev Neurol. 2004 Aug 1-15;39(3):201-4. PubMed
• 5. Shaygannejad V, Janghorbani M, Ghorbani A, Ashtary F, Zakizade N, Nasr V. Comparison of the effect of topiramate and sodium valporate in migraine prevention: a randomized blinded crossover study. Headache. 2006 Apr;46(4):642-8. PubMed
• 6. Salinsky MC, Storzbach D, Spencer DC, Oken BS, Landry T, Dodrill CB Effects of topiramate and gabapentin on cognitive abilities in healthy volunteers. Neurology. 2005 Mar 8;64(5):792-8. PubMed

Published: March 31, 2008
Last updated: January 09, 2010