REVIEW An anticonvulsant (antiepilepsy) drug. The exact mechanism of action is unknown. The properties that may contribute to topiramate's antiepileptic and antimigraine efficacy include a blockage of voltage-dependent sodium channels, an augmentation of gamma-aminobutyrate acid activity at some subtypes of the GABA- A receptors, antagonism of AMPA/kainate subtype of the glutamate receptor, and inhibition of the carbonic anhydrase enzyme, particularly isozymes II and IV .
Caricilli AM, Penteado E, de Abreu LL, Quaresma PG, Santos AC, Guadagnini D, Razolli D, Mittestainer FC, Carvalheira JB, Velloso LA, Saad MJ, Prada PO (2012). Topiramate treatment improves hypothalamic insulin and leptin signaling and action and reduces obesity in mice. Endocrinology. 153(9):4401-11. PMID 22822160.