Topiramate is a derivative of the naturally occurring monosaccharide d-fructose. It was originally synthesized to be a structural analog of fructose-1,6-diphosphatase as part of a project to develop agents that inhibit gluconeogenesis by inhibiting the enzyme fructose-1,6-biphosphatase (Shank et al. 2000). To date, however, it has not been shown by clinical evidence to have direct hypoglycemic activity. Topiramate contains a sulfamate moiety. The structural resemblance of this moiety to the sulfonamide moiety in the established antiepileptic drug acetazolamide prompted researchers to evaluate topiramate for possible anticonvulsant effects. Topiramate subsequently was shown to have potent anticonvulsant properties in a broad range of preclinical epilepsy models (Shank et al. 2000).