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Pharmacological action

Antiepileptic drug. Belongs to a class of sulfate-substituted monosaccharides.
Antiepileptic activity of the drug due to a number of its properties. Topiramate reduces the frequency of action potentials characteristic of the neuron in a state of persistent depolarization, which indicates that the dependence of blocking action of the drug on sodium channels on the state of the neuron. Topiramate potentiates the activity of GABA in certain subtypes of GABA-receptors (including the GABAA-receptor), and modulates the activity itself GABAA-receptors prevents activation of kainate sensitivity of the kainate / AMPK-receptors for glutamate, does not affect the activity of N-methyl -D-aspartate for NMDA-receptors. These effects are dose-related drug at a concentration of topiramate in plasma from 1 m to 200 microns, with minimal activity in the range from 1 uM to 10 uM.
In addition, topiramate inhibits some isoenzymes of carbonic anhydrase, but the effect of topiramate weaker than that of acetazolamide, and, apparently, is not central to the antiepileptic activity of topiramate. 

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