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It is believed to work through multiple pathways, including: Blocking voltage-gated 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 is uncertain While topiramate's primary indications are epilepsy and migraine prophylaxis, it has been observed to cause weight loss as a side effect, likely through appetite suppression and altered taste perception

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Some describe feeling food neutral or finding that they forget to eat

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