On this episode of the Real Life Pharmacology Podcast, I cover topiramate pharmacology. Topiramate is indicated for migraine prevention, seizures, and weight loss which are the most common uses that I see this medication used for. Topiramate has carbonic anhydrase activity, so rarely, use of this drug may induce metabolic acidosis. By far, the most common patient complaint I get with the use of topiramate is that it causes cognitive slowing or impairment.