Topamax side effects

It has helped many people reduce their migraine attacks, but Topamax side effects have also scared many patients away.  Over the past few years, the anticonvulsant topiramate (sold as Topamax) has been used a preventative, to avoid migraine attacks.  But what about the side effects - are they worth it?  Worse, are there permanent Topamax side effects?

A little background

It's not unusual for migraineurs to take anticonvulsants, which often have been helpful in fighting migraine attacks.  To get a bit of a background on this drug, read the article The Topamax migraine solution - a dream come true?

The problem of Topamax side effects

Side effects of Topamax
Though Topamax has helped many people, the problem is that it is a powerful drugs and can have side effects.  Of course, some people have very little trouble with it, others find the cure to be worse than the disease.  So it really comes down to how topiramate and your body get along, and how disabling and frequent your migraine attacks are.  In a recent post about Topamax side effects related to speech, we heard in the comments a frustration with a drug that was helping with the migraine attacks but causing other problems.

Topamax most common side effects

If side effects do bother people, most commonly, Topamax will slow you down, or make you feel like you're in a fog.  This includes slower reflexes, trouble thinking or concentrating, trouble thinking of the right word (and other speech problems), tiredness, poor coordination, and dizziness.



Topiramate may also cause tingling in your hands or feet, shakiness, depression, nausea, memory problems, and visual problems (such as double vision).  It has also been known to bring on respiratory infections.

(Note: early in 2008, the FDA in the USA released a report that topiramate and other antiseizure medication significantly increased the risk of suicidal thoughts or behaviour.  Special caution should be taken with those who are at risk or have a history of depression.)

Remember, it's not as if you're going to suffer from all these problems - they are simply the Topamax most common side effects, and you may not have much trouble, or may experience one or some of the above.

Topiramate may also cause birth defects if taken while pregnant.  It also passes into the breast milk.  Unless crucial, Topamax is not taken during pregnancy or breastfeeding.

Less common side effects

As with any drug, there is a large list of possible side effects.  But most things on the list are very rare.  If you do experience problems, it's nice to have the list so that you know what may be the cause.  But generally, these are not a reason to worry.

Some of the less common Topamax side effects include:  pain (ie chest, leg), mood changes (ie aggression, restlessness), rash, body odour, appetite loss and weight loss, constipation, hearing loss, and menstrual disorders.  Check here for a more complete explanation of Topamax side effects.  Also see this helpful article on topiramate at the Mayo Clinic.

Topamax and children

There has been less testing of topiramate in children.  However, in April 2008 a review was done of medical literature dealing with children with migraine.  The study found that topiramate has helped reduce migraine problems in children.  It also found that there was a drastic difference between patients when it came to side effects.  Common problems in children were weight loss, anorexia, abdominal pain, tiredness, trouble concentrating, and itchy or tingling skin (paraesthesia).

Though these problems did not always last, children are more prone to emotional and developmental problems, and so there should be extreme caution when using Topamax.  That just means, as with adults, knowing how serious the migriane attacks are, and making the judgement call on whether or not the treatment is "worth it".  Read more about the study Topiramate in the prevention of pediatric migraine: literature review.

One concern with topiramate is decreased sweating, which may cause problems in hot weather.  Children especially should be watched carefully for problems with hyperthermia.

Permanent Topamax Side Effects?

Are there permanent Topamax side effects?  Since topiramate is taken on a daily basis, there can be side effects which continue as long as you're taking the medication.  However, this isn't always the case.  Sometimes the side effects may come and go.  It's worthwhile to try the drug for several months if you can tolerate it, to get a good idea how it's going to act over the long term.

As with most drugs, these problems generally go away after you stop taking the drug.  However, you do need to talk to your doctor and make sure she knows your medical history before you start taking it.  For example, some people have allergies to topiramate.  Kidney problems can also result from taking Topamax, so be sure to let your doctor know if you have kidney disease.

Reducing the side effects?

Some problems can be reduced by avoiding drug interactions (talk to your doctor), and taking the drug as directed (not stopping suddenly or taking too much or too little).  It helps to drink several glasses of water a day to avoid possible development of kidney stones.

A note about Topamax weight loss side effects

Because one of the side effects of Topamax is weight loss, researchers have thrown around the idea of using it as a weight loss drug.  However, once again, the other side effects have been the problem.  In most cases research was soon abandoned because the drug caused too many problems, and there were too many far better options out there.

In conclusion

If you have a good doctor who knows your medical history, and who is willing to monitor your progress, you're off to a good start.

 Most doctors will have many more recommendations before topiramate, so be patient and try those first.  Remember, there are also many natural and non-drug treatments that have helped minimize migraine attacks, and most of these are much less likely to cause side effects.

If you do get to the point where you're wanting to try Topamax, it's going to be a continuous judgement call.  Every once in a while you're going to need to review (with the help of your doctor, family and friends) - how is Topamax affecting my life?  Is it still worth it?  Or is it time to try something else?  Using a good migraine diary before, during and after you take Topamax is crucial.

Topamax side effects, though important to understand, do not need to be the last word.  You may find that the treatment is worth it.