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Interaction with insulin, glucagon and epinephrine

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Data from pregnancy registries and epidemiologic studies indicate that a fetus exposed to topiramate in the first trimester of pregnancy has an increased risk of major congenital malformations, including but not limited to cleft lip and/or cleft palate (oral clefts), and of being small for gestational age (SGA)

It has also been noted to increase strength and endurance across the exercising human skeletal muscle

Heartburn or Acid Reflux: The compromised ability of the stomach to empty its contents effectively can lead to the regurgitation of stomach acids into the esophagus

BAK/BAX macropores facilitate mitochondrial herniation and mtDNA efflux during apoptosis