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Topiramate is a prescription medication used to treat and prevent certain neurological conditions. It’s most commonly prescribed for:
Topiramate is usually taken once or twice a day, depending on the dose and reason it's prescribed. For seizure treatment, most people take it twice daily (morning and evening), especially at higher doses. Some extended-release forms are designed to be taken once a day.
Topiramate works by calming overactive nerves in the brain. It helps restore balance between two important brain chemicals: GABA and glutamate.
GABA helps slow things down in the brain and keeps nerve activity under control. Glutamate does the opposite – it excites the nerves and gets them firing.
In conditions like seizures or migraines, the brain’s electrical signals can become too active or out of balance. Topiramate boosts the calming effects of GABA and reduces the stimulating effects of glutamate. This helps prevent the brain from becoming overstimulated, which can reduce seizures and lower the chances of a migraine starting.
You may qualify for topiramate if you have a condition it’s commonly used to treat, such as:
A healthcare provider will consider your diagnosis, medical history, current medications, and risk of side effects before prescribing it.
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Topiramate may be right for you if you have frequent migraines, seizures, or another condition your provider believes could benefit from calming overactive brain signals. It might also be considered for weight management or binge eating, depending on your health goals and history.
A healthcare provider will help decide based on your symptoms, medical history, and how well you might tolerate the medication. It’s not a good fit for everyone – especially if you’re pregnant, prone to kidney stones, or have a history of mood or cognitive issues.
The best way to know is to talk with your provider about your treatment needs and whether topiramate could help meet them safely.
No, topiramate is not a controlled substance. That means it’s not considered addictive or prone to abuse the way medications like opioids or stimulants are.
However, it’s still a prescription-only medication, and you should take it exactly as directed. Even though it’s not classified as controlled, it can cause serious side effects if misused, including mood changes, confusion, or fatigue – especially if doses are too high or stopped suddenly.
Yes, topiramate can support weight loss, though it’s not FDA-approved for this use on its own. It’s often prescribed off-label or included in combination medications like Qsymia® (topiramate + phentermine). It may help by reducing appetite.
Topiramate is also one of the three medications used in LifeMD’s Triple Therapy option in the Weight Management Program. This doctor-trusted treatment plan combines metformin, bupropion, and topiramate in carefully selected doses to support weight loss. If you’re considering treatment, the first step is to complete a free medical intake form through LifeMD. If you qualify, a provider will work with you to determine whether Triple Therapy – or another option – is right for your needs.
Yes, topiramate can cause hair loss in some people, though it’s not very common. Hair thinning or shedding may happen as a side effect, especially when starting the medication or changing doses.
If you notice significant hair loss after starting topiramate, talk with your healthcare provider. They can help determine if the medication is the cause and discuss ways to manage it or consider alternative treatments.
Constipation is not a common side effect of topiramate, but some people may experience changes in their digestion, including constipation or other stomach issues. If you notice constipation after starting topiramate, it’s a good idea to mention it to your healthcare provider. They can help you manage symptoms or adjust your treatment if needed.
Yes, topiramate can cause sleepiness or drowsiness, especially when you first start taking it or after a dose increase. This is a common side effect because it slows down certain nerve signals in the brain. If it makes you too tired, talk with your healthcare provider – they may adjust your dose or suggest taking it at a different time of day.
The most common side effects of topiramate include:
If any side effects become severe or interfere with your daily life, it’s important to talk with your healthcare provider.
Yes! With LifeMD, you can connect with a licensed healthcare provider from the comfort of your home within an hour. If appropriate, your provider may prescribe a medication and send it directly to your local pharmacy.
For even more flexibility, a LifeMD+ membership gives you 24/7 access to care, same-day prescription refills, exclusive wellness perks, and easy access to lab testing — all designed to make managing your health simple and stress-free.
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