Abstract
Topiramate is a second generation antiepileptic drug, with a wide range of anticonvulsive activity, both in experimental models and clinical trials. Topiramate has multiple mechanism of action including enhancement of GABA-A transmission and blocking the excitatory glutamate neurotransmission by AMPA and kainate receptors but not by NMDA receptors. Moreover, topiramate blocks sodium voltage channels as also calcium channels type L and decrease some of neurotransmitters
release, enhances the potassium ion channels as well as inhibits carbonic anhydrase. Topiramate is present approved for the treatment of epilepsy and migraine prevention in adults. Multifaceted mechanism of action of topiramate may explain its therapeutic activity also in other diseases. Numerous clinical trials confirm its efficacy in drug and alcohol dependence, eating disorder, neuropathic pains, mental diseases, the posttraumatic stress disorders, essential tremor or Gilles de la Tourette syndrome.