Topamax in combination with other antiepileptic medications was used in a treatment of 45 patients with different epilepsy types. The efficacy of topamax was shown in all types of epilepsy and in most types of epileptic seizures. Positive effect was revealed in 69% of the cases, in 22.5% complete remission was achieved. The best results were obtained in idiopathic generalized epilepsy (in respect to stopping generalized tonico-clonic seizures) and in the cases of symptomatic (cryptogenic) partial epilepsy (in the treatment of simple partial motor and secondary generalized seizures). Seizures aggravation was only 6.5% in complex partial and tonic axial paroxysms. In 19% of the patients, topamax efficacy decreased, with seizures frequency gradually returning to a baseline 1-3 months after the positive effect achievement. Side effects (SE) were detected in 24% of the cases. The most frequent ones were dose-dependent SE in relation to CNS in the absence of idiosyncratic reactions. Therapy withdrawal because of SE was necessary only in 11% of the cases. Topamax is considered a promising antiepileptic medication.