The Sound of Evolution
Topiramate
Mechanism of action:
Topiramate has multiple mechanisms of action. Topiramate blocks voltage-gated sodium channels in neurons, reducing excessive neuronal firing. It also enhances the inhibitory effect of GABA_A receptors, increasing chloride influx and causing neuronal hyperpolarization. In addition, it inhibits AMPA/kainate-type glutamate receptors, reducing calcium and sodium influx and suppressing excitatory synaptic transmission.
Reference(s):
1. Ford L et al. (2017). Comprehensive review of visual defects reported with topiramate. Clin Ophthalmol.
2. Brigo F et al. (2017). Topiramate in the Treatment of Generalized Convulsive Status Epilepticus in Adults: A Systematic Review with Individual Patient Data Analysis. Drugs.
3. Garnett WR et al. (2000). Clinical pharmacology of topiramate: a review. Epilepsia.