Topamax is used in addition to other seizure medicines to treat children with partial seizures, children with Lennox-Gastaut syndrome, and children with primary generalized tonic-clonic seizures.

Doctors figure out how much medicine to give to young children based mostly on their weight. To keep side effects at a minimum, the doctor probably will prescribe a low dose to start with and increase it slowly. Children usually start with a dose of 15 to 25 milligrams (mg) or less per day, based on a range of 1 to 3 mg per kilogram (kg, about 2.2 pounds) of body weight per day. This dose is given every night for the first week. The dose is usually then increased every week or two by adding 1 to 3 mg per kg per day (given in two divided doses) to achieve the best response. Most children do best at about 5 to 9 mg per kg per day.

If the dosage is increased slowly and carefully monitored, side effects should not be a problem for most children. The most common side effects involve problems with thinking or behavior, such as difficulty with concentration and attention or memory difficulty. These side effects may be less frequent in children than in adults. Headache, sleepiness, fatigue, and weight loss are other common side effects. Children are also less like to get the rare eye problem (glaucoma) – still, call the doctor immediately if the child experiences vision problems or eye pain.

One advantage of using Topamax for children is that it comes in the form of a sprinkle capsule, which can be swallowed whole or given by carefully opening the capsule and sprinkling the entire contents on a small amount (teaspoon) of soft food. This mixture should be swallowed immediately and not chewed. See How to take and store Topamax (part of the Introduction) for details.

Children should be monitored in hot weather to be sure they sweat appropriately. Topamax impairs sweating in a few children, leading to high body temperatures.

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