Used for epilepsy and migraine.

MHRA 2024 introduced pregnancy prevention programme, given risk of significant harm to unborn fetus (congenital malformation, low birth weight, potential increased risk of intellectual disability, autism/ADHD).

This stipulates that never used in pregnancy, but also not used in women of childbearing potential unless the conditions of the Pregnancy Prevention Programme are fulfilled, viz:

• are using highly effective contraception
• have a pregnancy test to exclude pregnancy before starting topiramate
• are aware of the risks from use of topiramate

If used, women of childbearing potential must sign a Risk Awareness Form.

To make things more complicated, topiramate interacts with pretty much all oral contraceptives to decrease their effectiveness…