Clinical pharmacology of topiramate: A review

Clinical success with an antiepileptic drug (AED) depends primarily on its efficacy and tolerability. Clinicians also need to have a basic understandi ng of an AED's pharmacokinetic characteristics, particularly those affectin g the potential for drug interactions such as hepatic enzyme inhibition or induction and protein-binding displacement. Successful treatment may be com plicated by pharmacokinetic characteristics such as a short half-life, nonl inear kinetics, and active metabolites. Pharmacokinetic characteristics tha t make a drug easy to use may affect patient adherence. In general, newer A EDs such as topiramate (TPM) are simpler to use than traditional AEDs becau se they have more favorable pharmacokinetic characteristics and fewer drug interactions.