A study says a higher dose of topiramate drug during the first tri-semester of pregnancy may up the risk of cleft lip or cleft palate more than when taking a lower dose. Topiramate is prescribed to prevent seizures in people with epilepsy. It is also used to prevent migraine headaches or treat bipolar disorder. In combination with phentermine it may be prescribed for weight loss. While topiramate is not recommended for pregnant women unplanned pregnancies are common so it's important to fully examine any possible risk said Sonia Hernandez-Diaz from the Harvard T.H. Chan School of Public Health in Boston.