Topiramate Dosing for Migraine Prevention

Special Considerations

Patients with both obesity and migraines may derive additional benefit from topiramate due to its weight-reducing effects 1
The American Academy of Family Physicians suggests that topiramate is particularly useful in patients with prolonged or atypical migraine aura 2

Women of reproductive potential must be informed that topiramate reduces the efficacy of hormonal contraceptives and carries teratogenic risk including neural tube defects and orofacial clefts 1, 3
Patients should be counseled about common adverse effects, including paresthesias, fatigue, decreased appetite, nausea, diarrhea, weight loss, taste perversion, and cognitive slowing, as recommended by Praxis Medical Insights 1
Topiramate should be discontinued gradually to minimize risk of increased seizure activity in susceptible individuals, as advised by Praxis Medical Insights 1