Topiramate therapy of a mother during pregnancy may be associated with a risk of oral clefts in the offspring.

Use of topiramate:

(1) epilepsy

(2) migraine

(3) appetite suppression

(4) psychiatric disorders



(1) therapy with topiramate during the first trimester (OR 6.3 in Alsaad et al)

(2) higher dose of topiramate (OR > 100 mg per day was 5.2 in Hernandez-Diaz et al)

(3) oral cleft (cleft lip, palate defect)

(4) exclusion of other diagnosis that may explain an oral cleft


Other anomalies may involve:

(1) skeleton (limb or hand)

(2) heart


A woman taking topiramate may benefit from contraception. This may avoid therapy before a woman realizes that she is pregnant.

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