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Topamax® Birth Defects

Topamax® is the brand name for a generic medication known as topiramate. It's an anticonvulsant medication with Food and Drug Administration approval for use in treating seizures in adults and children ages 10 and up, or in combination with other medications for treating seizures in children as young as two. Topamax® may also be taken regularly to help prevent migraine headaches, though it does not affect a migraine once it's started. Despite its various uses and subsequent successes in treatment, Topamax® has also been associated with certain side effects, including birth defects.

Topamax® and Pregnancy

Topamax is in FDA pregnancy category D. The FDA has rated drugs for their safety for use during pregnancy from category A (safe) to category X (not safe). Category D is one step above category X and means the FDA has found positive evidence of risk to the fetus. In some cases, the benefits to the mother of drugs in category D may outweigh the risks to the fetus.

Potential Risks and Birth Defects

Taking Topamax during pregnancy causes an increased risk of birth defects. In particular, a baby whose mother takes Topamax will be at risk for cleft lip and cleft palate. These defects can be caused very early in pregnancy, even before the mother realizes she's pregnant. For this reason, a woman who's planning to become pregnant should be as careful with Topamax as one who's already pregnant.

In addition, Topamax may decrease the effectiveness of hormonal birth control. A woman of child-bearing age who takes Topamax should talk to her doctor about using non-hormonal birth control, such as condoms, spermicide or a diaphragm, while she's on the medication. If a woman accidentally becomes pregnant while taking Topamax, she should discuss her options with her doctor immediately.

While Taking Topamax

There is not enough information available to know whether or not Topamax passes into breast milk and whether or not it could harm a breastfeeding baby. For safety's sake, a breastfeeding mother should discuss Topamax use with her doctor to find out if another medication would be better for her and her baby.

Most women will be better off avoiding Topamax during pregnancy. However, certain women who can't control their symptoms with any other medication or method may find the risks of being off medication more severe than the risks of being on it. No woman should make this determination on her own. Only a doctor can help her decide whether there is a better option than remaining on Topamax.

Additional Side Effects

Mild side effects of Topamax include dizziness, numbness, nervousness, diarrhea, weight loss, a change in taste or cold symptoms such as stuffiness or sore throat. Some people experience more serious side effects, such as vomiting, loss of appetite, irregular heartbeat, severe tiredness, dry mouth, increased thirst, high body temperature or severe pain on the left side. Other serious side effects include speech or balance difficulties, trouble with memory and concentration, or confusion.

As with most seizure medications, a few people experience thoughts of suicide or self harm. These should be discussed with a doctor immediately.

Some people experience vision difficulties while taking Topamax. These should be considered serious and discussed with a doctor. First signs of trouble may be a change in vision or feeling pain behind the eyes. This can lead to permanent vision loss if not addressed immediately. Seek immediate medical attention.