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HeadWay, Issue #057 -- Side effects of Topamax
April 21, 2008

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In this month's issue:

Side effects of Topamax

NoDoze and the caffeine controversy

Say what?!  Somnolence

Side effects of Topamax

It's obvious that a recent post at the Headache and Migraine News Blog struck a nerve. I was writing about a recent study showing that the drug topiramate (Topamax) causes language disturbances in some patients. People commented and emailed with their frustrations with Topamax - sure, it may help with the migraine attacks, but the side effects could be nasty!

Becky from the USA emailed, asking that we specifically talk about the side effects of topiramate. She said,"I know you have had many articles on Topamax but I would like to see one that specifically addresses side effects for those of us who are afraid after reading the insert that comes with the prescription!"

Well, Becky, you're not alone, and it's not just Topamax. Drug labels are enough to scare anyone! But let's take a quick look at Topamax itself.

What is Topamax?

Topamax, or topiramate, is a drug geared toward treating seizures. Like many anti-epileptic drugs, it has been used for migraine with some success. It's taken daily, as a preventative. Though it doesn't work for everyone, it has helped a lot of people. Read more about Topamax, dosages and clinical trials here.

Side effects

Topamax is a powerful drug, and so it should be way down the list of things you try for migraine.  One thing we learn as migraineurs is patience - it takes time to really try the treatments that are available, and each treatment works well for some people and not so well for others.

The most common problem with topirimate is that it can slow you down.  Side effects include slowed reflexes, trouble concentrating, thinking, or trouble thinking of the right word, tiredness, trouble with coordination, and dizziness.  It can also cause visual problems, trouble remembering, shakiness, depression, and nausea.

Obviously this can sound pretty scary, but there are some things you need to remember when reading any drug label.  First, these side effects do not affect everyone, and second, usually they do not all affect one person!  So you may take Topamax and have very little trouble.

Is it worth it?

So is it worth it to try Topamamx? If you're considering Topamax for the first time, you need to talk it over with a doctor that knows your medical history. There are a lot of treatments and drugs you can and should try first, drugs that have a much lower risk of side effects.

If you're already on Topamax, first you need to be patient. Keep a headache diary, and make a note of any side effects you think you may be experiencing. If your doctor feels you've been on the drug long enough to give it a decent try, it's time for the judgement call. Are the benefits outweighing the side effects? Is it time to try something else? This is something you will have to evaluate every once in a while, with any drug. Don't be afraid to tell your doctor if Topamax isn't working for you. You know yourself the best!

Here is a LOT more information on Topamax side effects.

NoDoze and the caffeine controversy

Here's another stimulating question from a reader. It has to do with caffeine, and caffeine pills such as NoDoz. David from the USA has noticed that a half a NoDoz tablet can help fight his oncoming headache. But he's concerned - could I get addicted? Is this a healthy solution?

NoDoz (or No-Doz) is one of several brands of caffeine in a tablet. Other brands include Jet Alert, Vivarin, Pro Plus, and Wake Ups. Each tablet typically contains 100-200mg of caffeine (a cup of coffee is about 100mg). As directed you take one tablet at a time, no more than 600mg per day. Of course, David is taking much less.

Caffeine in painkillers

Here's an important point. There is caffeine in a number of painkillers, but this is not just to give you the benefit of caffeine, but to enhance the other painkilling ingredients. In other words, the caffeine does a lot more than it would alone. It's not the same thing to just take a caffeine pill.

Can caffeine fight my headache?

The short answer is yes. As David discovered, caffeine can at times fight a headache. It can also cause a headache - caffeine doesn't work the same in every person, and doesn't work the same every time. And now we get to the controversial part.

The caffeine controversy

First is the question - is caffeine addictive?  The surprising answer is - well, yes and no.  In technical medical terms, caffeine is usually not considered addictive.  However, your body can experience withdrawal symptoms, and it can upset the balance of your body.  So... call it what you like, it can cause problems.

So a more important question is, will caffeine help me over the long term?  More and more doctors are recommending that headache sufferers stay away from caffeine altogether.  When it comes to headaches, especially headaches from migraine, keeping a balance is very important.  That means either keeping your caffeine consumption very regular, or simply cutting it out of your diet.

So, to answer David's question, it might be a short term help, but if you find you're taking them a lot you should probably go back to your doctor and start investigating a better solution.  The short answer is that there are probably many more far better solutions out there.

Do you want to know more about how caffeine works, why it helps with headaches, and what some concerns about it are?  Read the article:  What does the headache caffeine connection mean to you?

Say what?!  Somnolence

Somnolence is one of the possible side effects of topiramate.  It simply means drowsiness.  Try using that word next time you're in a dull meeting.
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