Topiramate, a sulfa-derivative monosaccharide was originally developed as a hypoglycemic agent, but was found to be devoid of hypoglycemic activity, and later, it was approved in 1995 in the UK as adjunctive treatment for partial-onset seizures. 1 Topiramate with several mechanisms of actions, by its long half-life, high oral bioavailability, low protein binding, renal elimination, and with little or no hepatic metabolism, proves to be an ideal migraine prophylaxis medication, and was approved in 2004 by the Food and Drug Administration. 2,3 Safety and efficacy of topiramate in the prophylactic treatment of migraine is well documented and it is evident that topiramate might be the therapeutic choice in patients not responding to classical first-line prophylactic treatment. 4 The increase in the horizon of topiramate use, leads to increase in the range of its adverse effects. Notable adverse effects are dizziness, slowed thinking, somnolence, ataxia, fatigue, confusion, weight loss, impaired concentration, and paresthesias. 5 The ophthalmological effect of topiramate, paresthesias, and itching were considered to be the treatment-emergent adverse reactions of topiramate. 6 This article aims to categorize the various adverse effects of migraine patients treated with topiramate.
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