To date, there is no high level evidence to support the efficacy of Topiramate in treating neuropathic pain. There is low level anecdotal evidence that suggests this medication may be beneficial in treating diabetic peripheral neuropathy and intercostal neuralgia. It is also worthwhile mentioning that, in general, there is very little information on this medication. With that in mind, and recognizing that you may see increasing requests for "approval" of this medication, we would suggest that you take some of the above into account, recognizing what little evidence there is, and also recognizing that there is really little information on this subject. Certainly, clinical judgement in each individual case would be required here.