A higher risk of severe birth defects is associated with the use of many anti-seizure medications by pregnant women, particularly during the first trimester of pregnancy.

FDA officials warn that pregnant women and women of childbearing age should discuss other treatment options with their health care professional before taking topiramate. Women taking topiramate should tell their health care professional immediately if they are pregnant or planning to become pregnant.

People taking topiramate should not stop taking it unless told to do so by their doctor.