Topiramate Topiramate is currently on the market under the trade name Topamax for adjunctive therapy in partial seizures in adults and children. Topiramate is currently being studied for treatment of mania. Open clinical trials have so far indicated that in monotherapy and in add-on therapy 50 to 60 percent of patients respond successfully, including treatment resistant, rapid cycling or mixed mania patients. The most frequent side effects found are numbness or tingling, drowsiness, psychomotor slowing, head-aches, nausea and weight loss. Most side effects are dose and titration rate dependent, and transient.
Side effects are also more frequent with add-on therapy.
If topiramate is added to other mood stabilizers, lowering the other mood stabilizer may be helpful. Recently published data have demonstrated that lamotrigine has antidepressant activity in patients with bipolar disorder. The drug was generally well tolerated and headache was the most commonly reported side effect. Other side effects included nausea, rash, and dizziness. Product information for Lamictal contains a boxed warning concerning severe, potentially life-threatening rashes that have been reported in association with Lamictal use.