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    Topamax Side Effects

    Topamax is a prescription medication that’s typically used to treat people who are prone to seizures or chronic migraines. However, like all medications, Topamax has side effects that you should be aware of before using it.

    At, we work hard to compile as much medication information as possible, so you can decide whether Topamax treatment is right for you.

    How Does Topamax Work?

    Topamax works by stabilizing the electrical nerve activity in your brain. The medication actively affects two of the brain’s neurotransmitters, which are natural chemicals in your brain that send messages between your nerve cells.

    Topamax medication enhances the GABA neurotransmitter, which acts as a natural nerve calming agent. It also decreases the action of your brain’s glutamate, the neurotransmitter responsible for exciting your nerves.

    These two actions together keep the electrical activity in your brain stable enough to hopefully prevent seizures and migraines.

    Additionally, Topamax helps prevent sodium from entering your nerve cells. Excess sodium levels cause rapid fire and repetitive electrical signals, which could cause a seizure or the onset of a migraine.

    What Are Some of the Common Topamax Side Effects?

    Topamax, which is also known as topiramate, does have some side effects — but all medications do. It’s important that you know which ones are possible and when you should contact your doctor if you have any of the common Topamax side effects.

    Keep in mind, side effects can happen with any dosage of the medication. For example, 100 mg Topamax side effects are the same as the Topamax 50 mg side effects.

    Some of the more common Topamax side effects include:

    • Tiredness
    • Drowsiness
    • Dizziness
    • Numbness or tingly of the hands and/or feet
    • Diarrhea
    • Nervousness
    • Coordination problems
    • Speech/language problems
    • Weight loss
    • Sensory distortion
    • Changes in vision
    • Bad taste in your mouth
    • Loss of appetite
    • Slowed thinking
    • Confusion
    • Memory problems
    • Trouble concentrating or paying attention
    • Cold symptoms such as coughing, sneezing, and a sore throat

    Are The Side Effects Immediate?

    In some cases, you might experience side effects almost immediately. You may feel tired or drowsy after taking your medication. Or you might notice that you have bouts of diarrhea shortly after taking Topamax.

    However, some of the more common side effects might take time to appear. For example, you might not notice memory problems, slowed thinking, or coordination problems right away.

    Because of this, it’s a good idea to track your symptoms as they come on throughout your initial stage of treatment, which typically takes about a month.

    Pregnancy Side Effects of Topamax

    If you discover you’re pregnant while you’re taking Topamax, you should notify your doctor right away. Overall, Topamax is considered a safe medication and some doctors recommend its continued use throughout the pregnancy.

    This is a decision that you need to make with your doctor. It’s your doctor’s job to weigh the risks for you and your baby.

    Topamax effects on baby aren’t fatal. However, it is possible for your baby to develop a cleft lip or cleft palate if you take it while you’re pregnant.

    Keep in mind, this condition usually develops during the first trimester of your pregnancy, so it’s a good idea to use birth control during your Topamax treatment and inform your doctor if you plan on trying to conceive.

    If this is the case, your doctor may want to lower your dosage or change your medication temporarily.

    Rare Topamax Side Effects

    In rare cases, Topamax has been known to cause kidney stones. While kidney stones aren’t overly alarming, they are very painful. You should notify your doctor if you have any symptoms of kidney stones including:

    • Severe back, abdominal, groin, or side pain
    • Painful urination or the frequent urge to urinate
    • Bloody or pink urine
    • Fever
    • Chills

    More Serious Topamax Side Effects

    One of the more serious side effects of Topamax is a sudden or unusual change in your mood, thoughts, and/or your behavior. It’s important to notify your doctor immediately if you have signs of depression, thoughts of harming yourself or others, or suicidal thoughts.

    You should also seek immediate medical treatment if you notice any of the following side effects:

    • Rapid breathing
    • Slow/fast/irregular heartbeat
    • Bone pain
    • Broken bones
    • Loss of consciousness
    • Unusual bruising or bleeding

    Are There Long-Term Side Effects or Harm Caused by Topamax Use?

    It’s possible for Topamax to cause osteoporosis, a condition in which bones can break easily, in older adults. It’s also possible for children taking this medication to develop rickets, which causes abnormal, curved bone growth.

    Another important note is that Topamax can slow a child’s growth, resulting in a decrease in the final height the child reaches.

    In rare cases, Topamax can cause a serious eye condition that results in permanent blindness. The condition usually begins with vision changes such as blurred vision, decreased vision, eye pain, or redness in the eyes.

    So if you have any of these symptoms, it’s important to contact your doctor immediately.

    Topamax’s Drug Identification Numbers

    Topamax comes in both tablet and capsule form. Both options come in numerous doses, and each of these has its own drug identification number.

    Topamax 25 mg tablet: 02230893
    Topamax 100 mg tablet: 02230894
    Topamax 200 mg tablet: 02230896
    Topamax 15 mg sprinkle capsule: 02239907 
    Topamax 25 mg sprinkle capsule: 02239908

    Topamax Dosage

    The amount of Topamax you’re prescribed depends on the problem you’re treating, your age, and your weight. It’s important to follow your doctor’s instructions completely during the initial phase of your treatment because the prescriptions are written in a way that it eases your body into taking the desired amount.

    Monotherapy Epilepsy Treatment Dosage

    When Topamax is used as a single-medication treatment for patients with epilepsy age 10 and older, 400 mg of Topamax per day is recommended. This is divided into two separate 200-mg doses, one that you should take in the morning and one you should take at night, before bed.

    The initial phase of treatment lasts six weeks total, and the daily dose of Topamax increases weekly as follows:

    • Week one: 25 mg
    • Week two: 50 mg
    • Week three: 75 mg
    • Week four: 100 mg
    • Week five: 150 mg
    • Week six: 200 mg

    Patients between the ages of two and nine who need Topamax to help prevent epileptic seizures are prescribed the proper dose for their weight. Children also follow an initial treatment plan that allows the doctor to slowly increase the dose on a weekly basis to reach the desired dose.

    Patient Weight (lbs) / Minimum Maintenance Dose (mg per day) / Maximum Maintenance Dose (mg per day)

    Up to 24 lbs / 150 mg / 250 mg

    25 to 48 lbs / 200 mg / 300 mg

    49 to 69 lbs / 200 mg / 350 mg

    70 to 83 lbs / 250 mg / 350 mg

    83+ lbs / 250 mg / 400 mg

    Adjunctive Therapy for Epilepsy Treatment

    When Topamax is used in conjunction with other medications to help prevent epileptic seizures in patients age 17 and older, the recommended dosage amount is between 200 mg and 400 mg per day.

    These doses are divided into a morning and night dose, and the amount taken during the first stage of treatment is increased slowly until the desired daily dose is reached.

    Epilepsy patients between the ages of two and 16 can take up to 400 mg of Topamax per day. However, the actual maximum dose varies with the patient’s weight.

    Typically, doctors prescribe between 5 mg and 9 mg of Topamax daily for every kilogram the patient weighs.

    Topamax For Migraines Dosage Limits

    People age 12 and older who have chronic migraines might be prescribed Topamax in an effort to prevent migraines from coming on. When used for migraine prevention, 100 mg of Topamax is the maximum daily dosage recommendation.

    These doses are also taken in two intervals — morning and night.

    During the initial stage of treatment, patients follow a four-week plan that increases the daily dose on a weekly basis.

    • Week one: no morning dose, 25 mg evening dose
    • Week two: 25 mg dose in the morning and evening
    • Week three: 25 mg morning dose and 50 mg evening dose
    • Week four: 50 mg morning and evening dose

    Efficacy For Seizures and Migraines

    It’s important to understand that Topamax is a preventative medicine. This means, it’s not used to treat seizures and migraines as they are happening.

    When taken properly, by following your doctor’s schedule, the medication alters your brain chemistry, keeping the electrical currents in your brain stable, which in turn, prevents your migraines or seizures.

    If you’re taking Topamax in order to prevent seizures, you may still have one occasionally. However, Topamax does also work to lessen the convulsions, so there’s less strain on your body if a seizure does occur.

    Is Topamax Right For You?

    Whether or not Topamax is right for you isn’t a question that can be answered online. If you believe that it could help you, you should discuss the option with your doctor.

    This lets you weigh the pros and cons to determine if it’s a good treatment option for you. In addition to discussing the risks of the medication, you should also consider the Topamax treatment cost before determining if it’s a good option for you.

    It’s also a good idea to review the Topamax treatment success rate with your doctor.

    When to Consult Your Doctor

    You should call your doctor right away if you have any of the rare or serious side effects listed above. Also, it’s important to contact your doctor if the symptoms you’re experiencing are severe or won’t go away.

    For example, it may be normal for someone taking Topamax to have bouts of diarrhea while their body adjusts to the medication, but if it’s happening constantly and doesn’t go away, your doctor needs to know about it.

    Risks of Topamax

    Most of the risks of Topamax aren’t serious. However, there are certain situations you need to discuss with your doctor before taking Topamax. 

    Do Not Take Topamax if:

    • You have glaucoma or other eye problems
    • You have diabetes or metabolic acidosis
    • You have kidney disease, kidney stones, or you’re on dialysis
    • You have lung disease or breathing problems
    • You have mood problems, depression, or you’re prone to suicidal thoughts or actions
    • You have liver disease
    • You have soft or brittle bones, osteoporosis, or osteomalacia
    • You have a growth disorder
    • You’re sick with diarrhea

    Topamax Interactions

    Topamax does interact badly with some medications, so you need to notify your doctor of any medications you’re taking before starting treatment. Some of the medications that interact badly with Topamax include:

    • Barbiturates
    • Contraceptives
    • Carbonic Anhydrase Inhibitors
    • Hydrochlorothiazide
    • Metformin
    • Valproic Acid Derivatives

    What Other Drugs and Treatments are Available for Seizures

    There are several medication options to consider for seizure treatment and prevention including:

    • Fycompa
    • Keppra, Keppra XL
    • Diamox
    • Tegretol
    • Aptiom
    • Trileptal
    • Banzel
    • Neurontin
    • Lyrica
    • Ganrene
    • Sabril
    • Gabitril
    • Potiga
    • Felbatol
    • Sodium Channel Modulators
    • Lamicatal
    • Dilantin
    • Zarontin
    • Celontin
    • Zonegran
    • Depakote
    • Depakene
    • Phenobarbital
    • Mysoline
    • Onfi
    • Klonopin, Epitril, Rivotril
    • Ativan
    • Valium

    What Other Drugs and Treatments are Available for Migraines

    There are also other medications available for treating chronic migraines including:

    • Almotriptan
    • Eletriptan
    • Frovatriptan
    • Naratriptan
    • Rizatriptan
    • Alsuma
    • Imitrex
    • Onzetra
    • Sumavel
    • Zembrace
    • Zomig
    • Dihydroergotamine
    • Ergotamine tartrate
    • Chlorpromazine
    • Droperidol
    • Metoclopramide
    • Prochlorperazine

    You can also use over-the-counter medications, such as Advil Migraine, Excedrin Migraine, and and Motrin Migraine Pain to treat migraines that are in process.

    How Many Cycles of Topamax Should You Try Before Moving On?

    Because Topamax is a preventative medication, it’s important to follow your doctor’s recommendation throughout your initial treatment period. During this time, discuss any and all concerns you have with your doctor.

    Depending on the side effects you experience, your doctor can help you decide if it’s better to continue the treatment or try another option.