side effects, dosage, reviews, how to take & discontinue, uses, pros & cons, and more
Brand & Generic Names; Drug Class
|US brand name: Topamax|
|Generic name: topiramate|
|Drug Class: AntiepilepticDrugs/Anticonvulsants|
|Learn More about Topamax’s Generic & Worldwide Availability|
Topamax’s Approved & Off-Label Uses (Indications)
US FDA Approved Treatment(s)
Epilepsy - by itself or with other meds, for adults & children. Migraines. Qsymia is topiramate combined with phentermine, and is approved to treat obesity.
Popular Off-Label Uses
How Long Until Topamax Starts Working (Onset of Action)
For migraines: anywhere from one day (don’t get your hopes up, but it happens) to a month.
For epilepsy: it’s complicated.
Likelihood of Working
For migraines: Really good, which is probably why OrthoMcNeil P-Diddy Janssen are all about Topamax for migraines these days.
For epilepsy: pretty good.
How to Take Topamax
For migraines: the initial dose is 25mg a day, increased by 25mg a day each week as needed until you reach 100mg a day, usually divided into two doses.
For epilepsy: the initial dose is 25mg a day, increased by 25mg a day each week until you reach 100mg a day, usually divided into two doses. If you’re still having seizures, the recommended increase is 50mg a day each week until you achieve seizure control or the recommended maximum of 400mg a day.
I Forgot Why I Cake Topamax
I <3 Topamax
How to Stop Taking Topamax (Discontinue, Withdrawal)
OrthoMcNeil MS-Passport now agrees with us. Per the PI sheet, unless you need to stop taking Topamax due to a severe adverse reaction, you should reduce your dosage by 25–50mg a day every week. Learn More about Taking and Discontinuing Topamax
Topamax’s Pros and Cons
Currently the only modern AED approved by the FDA that you can take by itself to treat both generalized, flopping around tonic-clonic seizures as well as partial seizures. You’re more likely to lose weight than gain weight. Can (but doesn’t always) work for migraines at 25mg a day with barely any side effects after a few weeks. Can (but doesn’t always) work for seizures at 100mg a day.
The promise of losing weight is oversold and often leads to disappointment. Topamax can make you dumber than a box of rocks.
Interesting Stuff your Doctor Probably didn’t Tell You about Topamax
Topamax may encourage you to stop smoking, in that you may just not like to smoke after you start and withdrawal symptoms won’t be as bad. Topamax can mess with lithium levels in seemingly random ways, and taking it along with Depakote or any other valproate can cause hypothermia (excessively low body temperature) and/or hyperammonemia (elevated ammonia in your blood), so taking Topamax to lose medication-induced weight gain can get tricky.
Best Known for
Turning you into the stereotype of a supermodel: thin and stupid.
In-Depth Pros & Cons
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Topamax’s Side Effects (Adverse Reactions)
Typical Side Effects
Sleepiness, fatigue, and/or lethargy. A pins & needles effect/tingling in the extremities that usually goes away after a week or two - but you want this one if you’re taking Topamax for migraines. Sodas and other carbonated beverages will taste like ass. Memory loss, aphasia (weird words coming out in place of what you meant to say or write), word find problems (not being able to recall the names of people, things or concepts), and a general cognitive impairment that has earned this drug the nicknames “Stupamax” and “Dopamax.”
Uncommon Side Effects
Dry and/or itchy eyes along with assorted vision problems. You may find yourself not able to drink coffee any more, so be prepared to quit the bean. Food in general, and not just carbonated beverages, may not taste quite the same. Frequent, intense déjà vu or jamais vu. If you were experiencing one prior to taking Topamax be prepared to experience the other.
Freaky Rare Side Effects
Tongue paralysis, neverending cough, staghorn calculus (I’d like to know how you do calculus using antlers), and palinopsia and the Alice in Wonderland syndrome. So Topamax explains Sarah Palin?
Learn More about Topamax’s Side Effects.
TMI at times
Medicated For Your Protection
What You Really Need to be Careful About
Glaucoma, not sweating, kidney stones.
topiramate’s Half-Life & How Long Until It Clears Your System
Half-life is the average time it takes for you to process half of the drug’s active ingredient. If a drug has a half-life of around 24 hours and you take a dose of 100mg, you’ll have roughly the equivalent a 50mg dose after one day, a 25mg dose after two days, and so on. The rule of thumb is: multiply the half-life by five and you get how long it is for the dose you took to be cleared from your bloodstream, so there’s nothing swimming around to attach itself to your brain and start doing stuff1. That’s called “plasma clearance.” Complete clearance is a complex equation based on a lot of factors which may or may not: be published in the PI sheet, include personal data like your weight, or even completely figured out by corporate and independent researchers. It usually winds up being 2–5 days after plasma clearance no matter what2, but can take weeks. Sometimes a drug will clear from your brain and other organs before it clears from your blood. If we’ve found the complete clearance, or how to calculate it if it requires things like your weight and what your piss looks like, you’ll find that on topiramate’s pharmacokinetics page.
How topiramate Works
the current best guess at any rateTopamax is a fairly broad-spectrum anticonvulsant. It prevents migraines and various types of seizures by blocking voltage-dependent sodium and calcium channels, inhibiting glutamate and carbonic anhydrase, and promoting the reception of GABA and/or increasing the amount of GABA, depending on the location in your brain and the study you read. Topamax may also affect voltage-sensitive sodium channels.
Learn More than You Probably Ever Wanted to Know about How topiramate Works
AKA mechanism/method of action, pharmacodynamics
Vaccines Cause Immunity
Mental Illness is NOT Contagious
Ratings, Reviews, Comments, PI Sheet, and More
Whichever nickname you use, Dopamax, Stupamax, or a supermodel drug, when it works Topamax is a freaking Godsend. I’m more than happy to put up with the frequent renal calculus (doctorese for the sediment in my piss that is more “kidney sand” and “kidney pebbles” than kidney stones), the hosed memory, the increased problems in getting the right words out of my mouth, and random periods of coffee = panic attacks so I don’t have to worry about having some kind of seizure activity a couple times a week or go through the hell that is ultradian rapid cycling.
With one of the simplest titration schedules and approval to be used as monotherapy (by itself) to treat generalized, flopping on the ground & pissing your pants seizures, Topamax will often be prescribed before Depakote or Stavzor - the newest flavor of valproic acid - even if the side effects for lower dosages of valproates often suck less than the side effects of Topamax at dosages required to treat some of those forms of epilepsy. Topamax side effects might suck more, but it is easier to take, so it’s a hard call as to which really sucks less.
Topamax (topiramate) has long been
As if I didn’t go on long enough already.
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Rating 2.9 out of 5 from 130 criticisms.
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If you’re still feeling judgmental as well as just mental3, please boost or destroy my self-confidence by honestly (and anonymously) rating this article on a scale of 0 to 5. The more value-judgments the better, even if you can criticize my work only once.
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Consumer experiences with and questions about Topamax on Crazymeds Topamax discussion board. Sign up for a free account to post your own.
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It’s always a good idea to check for drug-drug interactions yourself. Just because most people in the crazy meds business know about really important interactions (e.g. MAOIs and a lot of stuff, warfarin and everything on the planet) doesn’t mean the person who prescribed your meds told you about them, or the pharmacist has all the meds you take at their fingertips like they’re supposed to. Or they have the time to do their jobs properly when not dealing with complete idiots or playing Angry Farmers on the Faecesbooks.
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- Topamax’s Full US Prescribing Information
- Faught, Edward. “Topiramate in the treatment of partial and generalized epilepsy.” Neuropsychiatric disease and treatment 3.6 (2007): 811-821.
2 For crazy meds. I have no idea what the average complete clearance is for other types of medications. For all I know there are drugs that utterly vanish from your system in under five passes, and others that won't let go of your squishy bits for years after you stop taking them.
3 Thank you! I'll be here all weak. Be sure to tip your content provider. And don't try the veal, it's cruelicious!
4 These include: Canada's Product Monographs (PM), New Zealand's Medicine Data Sheets (MDS), the EU's European Public Assessment Reports (EPAR), and the Summary of Product Characteristics (SPC) used in Britain, Ireland, and many other places.
If you have any questions not answered here, please see the Crazymeds Topamax discussion board. We welcome criticisms of the articles, notifications of bad links, site problems, consumer experiences with medications, etc. I’m not always able to write back. Hence I never answer questions about meds via e-mail that are answered by this or other articles. Especially if they have been repeatedly asked on the forum. That’s why we write these damn things. Questions about which meds are best for your condition should also be asked on the forum; because this is a free site, so the price of admission is making things easier for somebody else searching for the same answer. We don’t deal with children on the forum or in private because after doing this for ten years I don’t have the emotional stamina to deal with kids who have brain cooties. How to contact Crazymeds. — Jerod Poore, CME, Publisher Crazymeds (crazymeds.us)
|Last modified on Sunday, 01 June, 2014 at 13:46:15 by JerodPoore||Page Author Jerod Poore||Date created Tuesday, 11 January 2011 at 13:43:23|
|“Topamax (topiramate): a Synopsis for the Educated Consumer.” by Jerod Poore is copyright © 2011 Jerod Poore||Published online 2011/01/11|
|Citation options to copy & paste into your article:|
|Plain text:||Poore, Jerod. “Topamax (topiramate): a Synopsis for the Educated Consumer.” Crazymeds (crazymeds.us). (2011).|
Topamax, and all other drug names on this page and used throughout the site, are a trademark of someone else.
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Almost all of the material on this site is by Jerod Poore and is copyright © 2004, 2005, 2006, 2007, 2008, 2009, 2010, 2011, 2012, 2013, and 2014 Jerod Poore. Except, of course, the PI sheets - those are the property of the drug companies who developed the drugs the sheets are about - and any documents that are written by other people which may be posted to this site will remain the property of the original authors. You cannot reproduce this page or any other material on this site outside of the boundaries of fair use copying without the express permission of the copyright holder. That’s usually me, so just ask first. That means if want to print out a few pages to take to your doctor, therapist, counselor, support group, non-understanding family members or something like that - then that’s OK to just do. Go for it! Please. As long as you include this copyright notice and something along the lines of following disclaimer, I’m usually cool with it.
All rights reserved. No warranty is expressed or implied in this information. Consult one or more doctors and/or pharmacists before taking, or changing how you take any neurological and/or psychiatric medication. Your mileage may vary. What happened to us won’t necessarily happen to you. If you still have questions about a medication or condition that were not answered on any of the pages you read, please ask them on Crazy Talk: the Crazymeds Forum.
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Nobody on this site is a doctor, a therapist, or a pharmacist. We don’t portray them either here or on TV. Only doctors can diagnose and treat an illness. While it’s not as bad as it used to be, some doctors still get pissed off by patients who know too much about medications, so tread lightly when and where appropriate. Diagnosing yourself from a website is like defending yourself in court, you suddenly have a fool for a doctor. Don’t be a cyberchondriac, thinking you have every disease you see a website about, or that you’ll get every side effect from every medication1. Self-prescribing is as dangerous as buying meds from fraudulent online pharmacies that promise you medications without prescriptions.
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1 While there are plenty of books to help you with hypochondria, for some reason there’s not much in the way of websites. Then again, staying off of the Internet is a large part of curing/managing the disorder.
2 Remember kids, Microsloth operating systems are like TOS Star Trek movies with in that every other one sucks way, way more. With TOS Star Trek movies you don’t want to bother watching the odd-numbered ones. With Microsloth OS you don’t want to buy and install the even-numbered ones. Anyone who remembers ME and Vista knows what I mean.
3 Have I mentioned how open source operating systems for commercial applications is one of the dumbest ideas in the history of dumb ideas? I don’t even need my big-ass rant any more. Heartbleed has made my case for me. And that’s just the one that got all the media attention. The very nature of an open source operating system makes security as much of an illusion of anonymity. Before you flip out too much: the domain Crazymeds is hosted on uses a version of SSL that is not affected by the Heartbleed bug. That’s one of the many reasons why I pay a lot of money and keep this site on Lunarpages.