Recommendations
Topiramate should not be used in monotherapy and unless new research shows otherwise, psychiatrists should assume that it has no mood-stabilizing properties.

Dose titration
Topiramate dose should be increased gradually and in two-weekly intervals.

Cognitive function
Topiramate is known to cause neurocognitive side effects. Psychiatrists should monitor their patients carefully for the emergence of such side effects.

Pregnancy
As with most other mood-stabilizers (anticonvulsants and lithium), women who may become pregnant should be warned of the possible consequences of taking such drugs during pregnancy [37].

Adequate hydration
Patients should be advised to ensure adequate hydration, especially if they are predisposed to nephrolithiasis [37].