FDA issues a warning regarding use of Topamax (Topiramate) during pregnancy

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Following several marketing surveillance reports, FDA issued a warning for the use of Topiramate or Topamax during pregnancy (especially in first trimester). This drug was found to cause increase incidence of cleft lip and/or cleft palate (oral clefts).

Topiramate or Topamax is primarily prescribed for epilepsy, bipolar disorder and various other nerve pains. Therefore, it is advised to take birth control, if you are on this drug. In addition, it is important to inform your doctor whether you are pregnant or planning to get pregnant.

However, most of other antiepileptic drugs are also known to cause various birth defects, if used during pregnancy. In addition, your doctor may decide to continue Topamax, if the risk of discontinuing the drug is higher (getting serious fits).
Sources
http://www.fda.gov/Drugs/DrugSafety/ucm245085.htm

Further reading
Side effects of Topamax