Topamax

(topiramate)

●●●●●
3.3/ 5 average rating with 56 reviewsforTopamax
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Prevents seizures and migraine headaches.

Skip Upsides & Downsides section. Skip to side effects section.

Our bottom line

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.

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    $281.86
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Quick facts about Topamax
  • Drug class: Neurology
  • Rx status: Prescription only
  • Generic status: Lower-cost generic available (topiramate)

Upsides

  • 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.
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What to expect from Topamax, on one page

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People’s experience with Topamax

56reviews so far. What do you think?

Downsides

  • 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.
Get our free fact sheet

What to expect from Topamax, on one page

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How it works

Topamax (topiramate) is an antiepileptic. Researchers don't know exactly how it works, but it controls seizures and migraines by increasing the effect of gamma-amino butyric acid (GABA), a chemical that calms nerve cells in the brain.

Quick facts about Topamax
  • Drug class: Neurology
  • Rx status: Prescription only
  • Generic status: Lower-cost generic available (topiramate)

Used for

Dosage forms

  • Pill
  • Extended release capsule
People’s experience with Topamax

56reviews so far. What do you think?

Prices and coupons

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What to expect when you take Topamax (topiramate) for Seizures

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  • First few hoursHours
    First few daysDays
    First few weeksWeeks
    First few monthsMonths
  • Effectiveness
  • Starts to kick in
    Full effects
  • First few hoursHours
    First few daysDays
    First few weeksWeeks
    First few monthsMonths
  • Possible side effects
  • Dizziness
  • Sleepiness
  • Weight loss
  • Burning/prickling sensation
  • Weakness
Skip side effects section. Skip to risks and warnings section.

Side effect rates for Topamax (topiramate)

From 199 clinical trials of Topamax when taken for adjunctive therapy for pediatric seizures (2 to 16 years old)
  • Sleepiness
    26%26%
    16%16%
  • Loss of appetite
    24%24%
    15%15%
  • Fatigue
    16%16%
    5%5%
  • Injury
    14%14%
    13%13%
  • Nervousness
    14%14%
    7%7%
  • Personality disorder (behavior problems)
    11%11%
    9%9%
  • Difficulty with concentration/attention
    10%10%
    2%2%
  • Weight loss
    9%9%
    1%1%
  • Aggressive reaction
    9%9%
    4%4%
  • Abnormal gait
    8%8%
    5%5%
  • Purpura
    8%8%
    4%4%
  • Difficulty sleeping
    8%8%
    7%7%
  • Viral infection
    7%7%
    3%3%
  • Impaired coordination
    6%6%
    2%2%
  • Nausea
    6%6%
    5%5%
  • Increased saliva
    6%6%
    4%4%
  • Muscle spasm
    5%5%
    4%4%
  • Constipation
    5%5%
    4%4%
  • Difficulty with memory
    5%5%
  • Pneumonia
    5%5%
    1%1%
  • Dizziness
    4%4%
    2%2%
  • Speech disorders/ related speech problems
    4%4%
    2%2%
  • Nose bleed
    4%4%
    1%1%
  • Confusion
    4%4%
    3%3%
  • Urinary incontinence
    4%4%
    2%2%
  • Stomach flu
    3%3%
    2%2%
  • Psychomotor slowing
    3%3%
    2%2%
  • Skin disorder
    3%3%
    2%2%
  • Allergic reaction
    2%2%
    1%1%
  • Abnormal reflexes
    2%2%
  • Thirst
    2%2%
    1%1%
  • Pussing
    2%2%
  • Hair loss
    2%2%
    1%1%
  • Dermatitis
    2%2%
  • Increased hair growth
    2%2%
    1%1%
  • Red skin rash
    2%2%
  • Eye abnormality
    2%2%
    1%1%
  • Abnormal vision
    2%2%
    1%1%
  • Leukopenia
    2%2%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Where we got our data »

The placebo bar shows how common a side effect was for people taking a sugar pill instead of Topamax.

Topamax (topiramate)
Placebo

People taking Topamax felt side effect more

People taking Topamax felt side effect less

No difference

Risks and Warnings for Topamax (topiramate)

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    • Higher risk if:
    • › History of depression

    Topamax (topiramate) can increase the risk of suicidal thoughts or behavior. Watch for worsening depression or any unusual changes in mood or behavior, especially during a person's first few months of treatment or when their dose changes. Be aware of changes in behavior that could indicate suicidal thoughts or depression, and report anything concerning to your doctor immediately.

Pharmacist Q&A

Topamax (topiramate) questions for

Frequently Asked Questions

This medication treats partial onset seizures, primary generalized tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome as add-on therapy in adults.

Who is this drug for?

This medication treats partial onset seizures, primary generalized tonic-clonic seizures, and seizures associated with Lennox-Gastaut syndrome as add-on therapy in adults.

Common concerns from people taking Topamax (topiramate)

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Alcohol
  • Worth it
    Worked well
    Low hassle
    Reviewed topiramateon 4/11/2019Prescribed it post detox for alcoholism to take at night. This is powerful stuff even with half a tablet. Had a similar effect to ambien.
    33
    Less than a week
    Alcoholism
Kidneys and liver
  • Topamax (topiramate) can increase the risk of kidney stones in children and adults (this is more likely for males). You can lower your risk of kidney stones by staying well hydrated and drinking a lot of water.
  • Worth it
    Worked well
    Some hassle
    Reviewed Topamaxon 9/17/2020 We just just increase My water intake for the day to help help prevent any kidney stones and I don’t drink caffeine do to heart & blood pressure problems This med is also helping with my seizures I have been talking for about a year now best of luck every one
    38
    Woman
    A year or so
    Migraine prevention
  • Not worth it
    Worked so-so
    Big hassle
    Reviewed topiramateon 8/19/2020That it can cause rare side effects, can effect the kidneys, and can disrupt the acid-base balance in the blood.
    37
    Man
    A few months
    Migraine prevention
  • Not worth it
    Worked so-so
    Big hassle
    Reviewed topiramateon 2/15/2020Control your urine and blood. I had kidney stones attacks every 6 months before doctors figure out what causes problem.
    46
    Man
    Two years or more
    Migraine prevention
Pain
  • Not worth it
    Didn’t work
    Low hassle
    Reviewed Topamaxon 10/8/2016If your eyes start to hurt, go see an optometrist or go to the ER. It can cause swelling of your eyeball, which can perm affect your eyesight. Been there, done that, and due to the dopy qualities I didnt react strongly enough to the pain.
    43
    Woman
    Migraine prevention
  • Worth it
    Didn’t work
    Some hassle
    Reviewed Topamaxon 7/16/2015Still get migraines but they're tolerable headaches usually and don't even require pain meds. Tingling subsided after a couple of months. Minor brain fog worth the migraine abatement. Don't mind the weight loss either.
    61
    Woman
    Two years or more
    Migraine prevention
Sex
  • Not sure
    Worked well
    Low hassle
    Reviewed Topamaxon 7/23/2016I can't have an orgasm on that pill
    25
    Man
    Migraine prevention
Sleep
  • Worth it
    Worked so-so
    Some hassle
    Reviewed topiramateon 4/14/2020I've lost about 15 pounds in a few months on Topamax. The drowsiness is worst when you first start taking it or increase the dose and seems to go away after a week or two. Since taking it I sometimes have trouble remembering certain words which can be inconvenient but isn't the worst thing ever. I seem to cry more on this medicine as well, I think. All in all, I'm fairly satisfied with it because it's helping my binge eating and bringing my weight down.
    26
    Woman
    A few months
    Eating disorder
Weight
  • Not worth it
    Didn’t work
    Big hassle
    Reviewed Topamaxon 11/18/2015Caused abdominal pain, diarrhea and weight loss for the first month. Caused cognitive problems - couldn't concentrate and would completely blank on certain words, specifically names.
    32
    Woman
    A few months
    Migraine prevention
  • Not worth it
    Worked so-so
    Some hassle
    Reviewed Trokendi XRon 10/2/2019Lost a lot of weight but lost a lot of hair also. Looked like I was in chemotherapy!
    45
    Woman
    Two years or more
    Seizures
  • Not worth it
    Didn’t work
    Some hassle
    Reviewed Topamaxon 8/16/2016Makes you gain weight
    31
    Woman
    Migraine prevention