Whether a first-timer mother or not, would you make a choice that would be beneficial to your health but would put your baby at risk of birth defects or would you choose otherwise by putting your baby’s welfare before yours? However, there is a catch, what if by making your baby’s health a priority; you are still putting both of you in danger by leaving your condition untreated? Such is the predicament that an epileptic mother undergoing the Topamax treatment is faced with. It is then a wonder how Topamax is sometimes prescribed for Bipolar Disorder when the US Food and Drug Administration (FDA) have not approved it for such use especially when confronted with this serious side effect.

Topamax with its active ingredient Topiramate is an anticonvulsant manufactured by Ortho-McNeil, a subsidiary of Johnson & Johnson. It was approved by the FDA for the treatment of epileptic seizures in 1996 and indicated for the prevention of certain types of migraine headaches in 2004. Studies on Topamax’s efficacy on other conditions such as psychiatric disorders and even weight loss were conducted despite these.

A new data from the North American Antiepileptic Drug Pregnancy Registry which showed that pregnant women taking Topamax are putting their unborn infants in an increased risk for cleft lip or palate was announced by the FDA, thrusting the Topamax side effects into the public even when all medications have side effects, both serious and minor. The discovery of birth defects linked to Topamax has become the most serious yet so far among all of the drug’s side effects. The data is not the first to link the anticonvulsant to serious birth defects though as studies with the same results were published in the United Kingdom since 2008. Those studies prompted US researchers to conduct the same investigation.

Healthcare professionals were urged to discuss with their patients of childbearing age alternative treatments and even effective birth control methods by the FDA which was prompted by the seriousness of these birth defects. Other Topamax side effects considered to be serious are:

• Lowered bicarbonate levels in the blood resulting in an increase in the acidity of the blood (metabolic acidosis)
• Serious eye problems which could lead to blindness
• Symptoms of kidney stones



Considered less serious common side effects and usually experienced during initial Topamax treatment are:

• Paresthesia or numbness and tingling of extremities
• Fatigue
• Taste change
• Weight loss
• Difficulty with concentration/attention and difficulty with memory
• Loss of appetite
• Nausea
• Diarrhea

For immediate intervention and so as not to worsen their condition, patients are advised to immediately report the persistence or worsening of these side effects, whether considered serious or not.