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It is believed to work through several pathways: Blocking voltage-dependent sodium channels , reducing neuronal excitability Enhancing GABA (gamma-aminobutyric acid) activity , an inhibitory neurotransmitter Antagonising glutamate receptors , further dampening excitatory neurotransmission Inhibiting carbonic anhydrase enzymes , though the clinical significance of this effect varies Topiramate is taken orally, typically once or twice daily

N Engl J Med 387(3):205216 Lespessailles E, Paccou J, Javier RM et al (2010) GRIO scientific committee

0.5 mg, n = 2 and one participant reduced to 1.7 mg before withdrawing)

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