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In a mouse model of diabetes, topiramate effectively protected the brain from diabetes-induced damage by reducing 4-HNE levels and increasing glutathione (GSH) levels ( However, in a study on the potential toxic effects of topiramate on the liver and kidney of male mice, topiramate significantly decreased the activities of the antioxidant enzymes SOD and CAT, while increasing MDA and NO levels ( In vitro study found that topiramate increased MDA, NO and ROS production in astrocytes, showing a dose-dependent negative effect ( These findings suggest that topiramate may exert dual effects on oxidative stress, offering neuroprotection in certain contexts while exacerbating oxidative stress under different conditions and dosages