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doi: 10.1038/s41573-025-01183-8

It is believed to work through several pathways: Blocking voltage-dependent sodium channels , reducing neuronal excitability Enhancing GABA (gamma-aminobutyric acid) activity , an inhibitory neurotransmitter Antagonising glutamate receptors , further dampening excitatory neurotransmission Inhibiting carbonic anhydrase enzymes , though the clinical significance of this effect varies Topiramate is taken orally, typically once or twice daily

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Supplements like fiber supplements, probiotics, and B vitamins can support digestive function and energy levels during the transition period

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These typically improve with gradual dosing, smaller meals, and adequate hydration