Compare Lamictal vs. Topamax

Head-to-head comparisons of medication uses, side effects, ratings, and more.

Lamictal (Lamotrigine)

Prescription only

Topamax (topiramate)

Prescription only
Prevents seizures and stabilizes mood.

Lamictal (Lamotrigine) is most useful for treating severe seizure disorders, and for bipolar disorder with more depression symptoms than manic symptoms. Just be careful to increase your dose slowly to avoid skin rash.

3.7/ 5 average rating with 184 reviewsforLamictal
Prevents seizures and migraine headaches.

Topamax (topiramate) is very effective at preventing many types of seizures and migraines, but it can cause several severe side effects that can lead to stopping the medication.

3.3/ 5 average rating with 56 reviewsforTopamax
Upsides
  • Effective at lowering the frequency of seizures in people with epilepsy or Lennox-Gestaut syndrome. Typically used together with other medications for severe seizure disorders.
  • Works best for partial, tonic-clonic, and absence seizures.
  • A first-line treatment for bipolar disorder. Effective long-term treatment for stabilizing mood. Prevents both depressive and manic episodes, but the effect is greater for preventing depression.
  • Doesn't require routine blood tests.
  • Can lower your number of seizures and also prevent migraine headaches. This medicine can be used on its own or with other antiepileptic medicines to lower the frequency of seizures.
  • Doesn't need routine blood tests like similar medications.
  • Available in short-acting and long-acting forms.
  • Comes as a generic, so it's relatively cheap.
Downsides
  • Can cause double vision, dizziness, sleepiness, and headache.
  • Has the risk of a rare but life-threatening rash.
  • Can make hormonal birth control less effective.
  • Might be less effective than other medicines for treating manic episodes (acute mania) in people with bipolar disorder.
  • Can cause many severe side effects. People starting Topamax (topiramate) need to be monitored for these effects as soon as they start treatment.
  • This medicine can take 4 to 6 weeks for the full effects of this medication to kick in, especially for people taking it for migraines.
  • Children taking Topamax (topiramate) for long periods of time need to have their dose adjusted by their pediatrician as they grow.
  • At higher doses (ie. 400 mg/day), children may experience difficulty with concentration/attention, fever, flushing, and confusion.
Used for
Dosage forms
  • Pill
  • Extended release
  • Chewable tablet
  • Dissolving tablet
  • Pill
  • Extended release capsule
Price
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Reviews
184 reviews so far
66%
saidit'sworth it
58%
saiditworked well
18%
saidit'sa big hassle

Have you used Lamictal (Lamotrigine)?

Leave a review
56 reviews so far
52%
saidit'sworth it
50%
saiditworked well
36%
saidit'sa big hassle

Have you used Topamax (topiramate)?

Leave a review
Side effects
36possible side effects
  • Dizziness
    38%
  • Headache
    28%
  • Diplopia
    28%
  • Ataxia
    22%
  • Nausea
    19%
  • Blurred vision
    16%
  • Somnolence
    14%
  • Rhinitis
    14%
  • Pharyngitis
    10%
  • Rash
    10%
  • Vomiting
    9%
  • Cough increased
    8%
  • Flu syndrome
    7%
  • Dysmenorrhea
    7%
  • Fever
    6%
  • Diarrhea
    6%
  • Incoordination
    6%
  • Insomnia
    6%
  • Abdominal pain
    5%
  • Dyspepsia
    5%
  • Constipation
    4%
  • Tremor
    4%
  • Depression
    4%
  • Anxiety
    4%
  • Vaginitis
    4%
  • Convulsion
    3%
  • Irritability
    3%
  • Speech disorder
    3%
  • Pruritus
    3%
  • Vision abnormality
    3%
  • Neck pain
    2%
  • Reaction aggravated (seizure exacerbation)
    2%
  • Anorexia
    2%
  • Arthralgia
    2%
  • Concentration disturbance
    2%
  • Amenorrhea
    2%
See more detailed side effects
39possible side effects
  • Sleepiness
    26%
  • Loss of appetite
    24%
  • Fatigue
    16%
  • Injury
    14%
  • Nervousness
    14%
  • Personality disorder (behavior problems)
    11%
  • Difficulty with concentration/attention
    10%
  • Weight loss
    9%
  • Aggressive reaction
    9%
  • Abnormal gait
    8%
  • Purpura
    8%
  • Difficulty sleeping
    8%
  • Viral infection
    7%
  • Impaired coordination
    6%
  • Nausea
    6%
  • Increased saliva
    6%
  • Muscle spasm
    5%
  • Constipation
    5%
  • Difficulty with memory
    5%
  • Pneumonia
    5%
  • Dizziness
    4%
  • Speech disorders/ related speech problems
    4%
  • Nose bleed
    4%
  • Confusion
    4%
  • Urinary incontinence
    4%
  • Stomach flu
    3%
  • Psychomotor slowing
    3%
  • Skin disorder
    3%
  • Allergic reaction
    2%
  • Abnormal reflexes
    2%
  • Thirst
    2%
  • Pussing
    2%
  • Hair loss
    2%
  • Dermatitis
    2%
  • Increased hair growth
    2%
  • Red skin rash
    2%
  • Eye abnormality
    2%
  • Abnormal vision
    2%
  • Leukopenia
    2%
See more detailed side effects
Risks and risk factors
  • Suicidal thoughts or behavior
    • History of depression
  • Serious skin rash
    • People also taking Depakote
    • Taking more than the prescribed dose
    • Increasing the dose too quickly
  • Serious allergic reactions
  • Blood disorders
  • Meningitis
  • Interactions with birth control pills
    • Taking birth control pills
  • Withdrawal seizures
    • Stopping Lamictal (Lamotrigine) suddenly
See more detailed risks and warnings
  • Suicidal thoughts or behavior
    • History of depression
  • Fever and inability to sweat
    • Children
  • Mental and cognitive changes
    • History of metabolic disorders
    • People also taking Depakote
  • Kidney stones
    • Low-carb diet
    • Dehydration
    • Drug interactions
  • Vision problems
  • Withdrawal seizures
    • Stopping Topamax (topiramate) suddenly
See more detailed risks and warnings