Topamax is a brand of topiramate, an anticonvulsant drug employed to stop seizures and cut back the frequency of migraines.
While its actual mechanism of action is unknown, studies suggest Topamax may alter the production or action of neurotransmitters in the brain, suppressing the abnormal activity of the nerves in the brain that cause seizures or preventing the abnormal activity from spreading to different nerves. Another analysis has suggested that it may suppress the nerves directly, thereby rendering them less inactive to fire.

It’s used to stop migraine headaches from occurring in those from 12 years and older. It can not be used to treat a headache that has already begun, however, it may help to reduce the amount of painful migraine.

Doctors often prescribe Topamax off-label to regulate binging and purging and promote weight loss in individuals with eating disorders such as bulimia nervosa and binge-eating disorder.

The drug is seen as an alternative when first-line medical aid with selective monoamine neurotransmitter uptake inhibitors (SSRIs) have failed to attain results.
It is unclear why Topamax is effective for these uses; but, it is believed that similar properties that enable it to regulate migraines and seizures conjointly work to inhibit the brain networks that cause food cravings.

Although there are a variety of studies supporting the effectiveness of Topamax for weight loss, there remain some issues concerning its long-term safety. Additionally, the drug has worrying, sometimes serious negative effects.

As a result, it’s not the first-choice treatment for weight loss in patients with eating disorders.

According to tips published by the American psychiatric Association (APA), Topamax is recommended only if alternative treatments have been ineffective. The APA conjointly notes that as a result of it causes weight loss, Topamax is also problematic if you’re of normal weight or are underweight.
Topamax should solely be used as prescribed, and under the supervision of a healthcare professional. If you have an eating disorder, ask your doctor if Topamax is an option for you.


Topamax can cause serious eye issues that, if left untreated, may cause permanent vision loss. These include a sudden decrease in vision that may be accompanied by eye pain and redness, in addition to a blockage of fluid within the eye resulting in secondary angle closure glaucoma.
Topamax might decrease sweating and increase your body temperature leading to a fever. Some individuals may have to be hospitalized if this happens.
Using this drug might increase the amount of acid in your blood, inflicting you with metabolic acidosis. Symptoms could embody loss of appetite, feeling tired, changes in your heartbeat, or having problems thinking clearly.

If metabolic acidosis isn’t treated, it might cause brittle or soft bones resulting in osteoporosis or other conditions. It might additionally lead to kidney stones or slow the rate of growth in kids.

In a small range of individuals, Topamax has been known to cause self-destructive thoughts or actions, anxiety, irritability, and depression in addition to feelings of agitation, restlessness, aggression, panic attacks, mania, and sleep disorder.

This medication might also cause drowsiness and impact your ability to think, causing confusion and problems with concentration, attention, memory, and speech.
Don’t stop taking Topamax without first talking to your doctor. Quitting suddenly could lead on to serious health issues.
To help your doctor decide if he/she ought to prescribe Topamax, you need to disclose all of your medical conditions and state whether or not you’re allergic to the drug. Tell your doctor if you have got these subsequent conditions:
• Kidney disease
• Have severe respiratory problems
• Glaucoma or another eye condition
• Osteoporosis
• Osteomalacia
• History of mood disorders like depression or suicidal thoughts and actions
• Diarrhea

Side Effects

Some side effects of Topamax could disappear once your body gets used to the medication. If they do not go away or worsen, let your doctor know. The most common complaints in this class are tremors and breast pain in the ladies.

Some of the less common side effects could include leg, chest, and back pain along with constipation, heartburn, increased sweating, and hot flushes.
Side effects that need you to talk with your doctor right away:
• Blurred or speedily decreasing vision
• Eye pain and redness
• Increased eye pressure
• Confusion
• Dizziness
• Drowsiness
• Burning, prickling or tingling sensations
• Nervousness
• Clumsiness/unsteadiness

Other symptoms that need attention:
• Continuous, uncontrolled eye movements
• Memory problems
• Menstrual pain and changes
• Slowing of mental and physical activity
• Trouble concentrating
• Unusual weakness or weariness
• Speech/language issues

Serious Side Effects
• Mood changes like aggression, agitation, apathy, and depression
• Loss of appetite
• Weight loss
• Stomach pain
• Fever, chills or sore throat
• Reduced sensation or perception
• Red, irritated, or bleeding gums

Rare side effects:
• Blood in urine
• Frequent, difficult or painful urination
• Loss of bladder management
• A decrease in sexual performance/desire
• Hearing issues
• Skin rashes
• Itching
• Swelling
• Nosebleeds
• Pale skin
• Lower back or side pain


Topamax is obtainable in tablets (25 milligrams (mg), 50 mg, 100 mg, and 200 mg), extended release oral capsules (25 mg, 50 mg, 100 mg, 150 mg, 200 mg), and sprinkle capsule (15 mg and 25 mg) that can be taken orally or sprinkled onto soft food.
Those who take Topamax usually begin with a low dose of 25 or 50 mg per day (divided over 2 doses), increasing it slowly by 25 to 50 mg per week till an effective daily dose is reached.

In the case of adults and kids 10 years or older, the dose is also increased by 100 mg at week 5 and 6 if Topamax is used by itself. The recommended adult dose is 200 mg, two times daily.

Children should begin with up to 25 mg taken every night for the first week, with the dose being increased at 1 or 2 week intervals. The utmost maintenance dose is predicated on weight.

Migraine patients are normally given 25 mg nightly for the primary week, with the dose being increased by 25 mg weekly. The maximum dose is 50 mg, twice every day.

Be sure to drink enough fluids to assist minimize your risk of kidney stones.


If you’re thinking that you have taken an excessive amount of Topamax, contact your doctor immediately.
Signs of an overdose might include:
• Decreased awareness or responsiveness
• Drowsiness
• Dullness
• Tiredness
• Weakness
• Dizziness, lightheadedness when getting up suddenly from a lying or sitting position.

Missed Dose

If you miss a dose, take it as soon as you remember. However, if you’re within six hours of your next dose, skip the missed dose and continue along with your regular schedule. Never take extra to catch up. If you forget many one dose, contact your doctor.