Topamax (topiramate) is used to prevent seizures and migraines, and is sometimes prescribed off-label to offset weight gain in people taking antidepressants. When taken during pregnancy, Topamax can cause oral birth defects including cleft lip and cleft palate.

Topamax Uses

Topamax is prescribed to control seizures in people with Lennox-Gastaut syndrome and epilepsy. It is also prescribed to prevent migraines.

Because weight loss is a side effect of Topamax, it is sometimes prescribed off-label as a weight loss drug.

Topamax may also be prescribed off-label to treat bulimia, binge-eating, bipolar disorder, obsessive-compulsive disorder, borderline personality disorder, and substance abuse.

Greatest Danger during First Trimester of Pregnancy

The risk of oral birth defects due to Topamax use is compounded by the fact that the drug is most likely to cause this type of birth defect during the first three months of pregnancy. Women are often unaware of pregnancy during this early stage.

To make matter worse, Topamax reduces the efficacy of birth control pills, increasing the likelihood that pregnancy will be unexpected and go undiscovered during the period of highest risk.

Oral Clefts

Today, in developed countries, oral clefts are rarely fatal. However they can cause serious health problems and have permanent consequences.

Babies with oral clefts require special care including special feeding techniques. Parents and other caregivers must be on constant lookout for signs of infections and other health issues.

Oral clefts can result in:

  • Difficulty nursing
  • Poor growth
  • Milk flowing through nasal passages while nursing
  • Ear infections
  • Hearing problems
  • Misaligned teeth
  • Speech problems

Oral clefts are corrected surgically, but even when treatment is successful the permanent consequences can include:

  • Lip deformity
  • Nasal deformity
  • Facial scaring
  • Displaced teeth
  • Dental cavities
  • Recurring ear infections
  • Hearing loss
  • Speech problems


Using Topamax during pregnancy puts your baby at risk for birth defects. However, seizures during pregnancy can be dangerous for both you and your baby. Women who discover that they are pregnant while taking Topamax should not stop using the drug without talking to their doctors about alternatives.

Women who intend to become pregnant should talk to their doctors about a safer way to control seizure. Women who do not wish to become pregnant need to be aware that Topamax reduces effectiveness of birth control pills and should talk to their doctors about the heightened risk of becoming pregnant while taking the drug.

If you or your significant other took Topamax during pregnancy and your child was born with oral cleft, you may be entitled to compensation that can pay for your child’s medical care and more. Please talk to a local Topamax injury attorney right away.