History and Discovery | Structure–Activity Relations | Pharmacological Profile | Pharmacokinetics and Disposition | Mechanism of Action | Indications and Efficacy | Side Effects and Toxicology | Drug–Drug Interactions | Conclusion | References
Topiramate is a derivative of the naturally occurring monosaccharide d-fructose.
It was originally synthesized to be a structural analog of fructose-1,6-diphosphatase
as part of a project to develop agents that inhibit gluconeogenesis
by inhibiting the enzyme fructose-1,6-biphosphatase (Shank et al. 2000). To date, however, it has not been shown by
clinical evidence to have direct hypoglycemic activity. Topiramate
contains a sulfamate moiety. The structural resemblance of this
moiety to the sulfonamide moiety in the established antiepileptic
drug acetazolamide prompted researchers to evaluate topiramate for possible
anticonvulsant effects. Topiramate subsequently was shown to have
potent anticonvulsant properties in a broad range of preclinical
epilepsy models (Shank et al. 2000).