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Topiramate enhances gamma-amino-butyric acid effects, has anti- glutaminergic effects, and is a state-dependent sodium channel blocker. 1 It is registered as an adjunctive treatment for epilepsy but is not registered for psychiatric indications. Nevertheless, it may be useful beyond its initial indication, considering the promising literature on which I report below. However, much more research evidence is needed to establish sufficient scientific justification for prescribing it routinely for psychiatric purposes.