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> Topamax


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Topamax Index | Brand and Generic Availability
Everything on Two Big-Ass Pages

Brand & Generic Names; Drug Class

US brand name: Topamax
Generic name: topiramate
Drug Class: AntiepilepticDrugs/Anticonvulsants
More on 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

Bipolar disorder (works best as an add-on). Eating disorders - especially sleep eating. Alcoholism. PTSD. Used by itself for weight loss - especially for weight gain caused by other crazy meds.

Details about Approved & Off-label Uses

Topamax’s Usual Onset of Action (when it starts working)

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 Ortho-McNeil “P-Diddy” Janssen are all about Topamax for migraines these days.


For epilepsy: pretty good. More on Chances of Working for You and Comparisons with Other Drugs

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.

How to Stop Taking Topamax (discontinue / withdrawal)

Ortho-McNeil 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.

More about Taking and Discontinuation



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Pros and Cons

Pros

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.

Cons

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

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

Topamax’s Side Effects

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 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?
Side Effect Details.
TMI at times


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What You Really Need to be Careful About

Glaucoma, not sweating, kidney stones.

Black box and other warnings, pregnancy category, etc.

Half-Life & Clearance

Half-life: 21 hours. Clearance: four to five days.
Pharmacokinetics Information Overload

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 the pharmacokinetics page.

How topiramate Works

the current best guess at any rate
Topamax 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.

More than You Probably Ever Wanted to Know about How a Drug Works
AKA mechanism/method of action, pharmacodynamics

Ratings, Reviews, Comments, PI Sheet, and More

Topamax Comments

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
Extended Comments
As if I didn’t go on long enough already.

Topamax Ratings & Reviews, and Consumer Comments & Experiences

Rate Topamax

Give your overall impression of Topamax on a scale of 0 to 5. Detailed ratings and reviews are available on the Topamax Ratings & Reviews Page.

Get all critical about Topamax

3 stars Rating 3.0 out of 5 from 74 criticisms.
Vote Distribution: 13 – 1 – 15 – 10 – 14 – 21


Rate this article

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.

Get all judgmental about the Topamax (topiramate) Synopsis

4.5 stars Rating 4.2 out of 5 from 38 value judgments.
Vote Distribution: 0 – 2 – 1 – 1 – 18 – 16


Full US Prescribing Information / PI Sheet

Allegedly Useful Links. Mostly official sites, PI sheet-equivalents4 from countries other than the US, and reviews from other consumer review sites.

Drugs.com’s drug-drug and drug-food interaction checker

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 Index | Brand and Generic Availability
Everything on Two Big-Ass Pages

1 Based on Julien's calculations from A Primer of Drug Action, the half-life multiplied by five is the generally accepted estimate of how long it takes a single dose of any given drug to be eliminated from the blood stream/plasma of someone with a normal metabolism. That's also the rough estimate for steady stage if they can't get, or won't provide a number for that.

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.

(:descript Topamax side effects, dosage, reviews, uses, how to take & discontinue, pros & cons, generic availability & equivalents, comparisons with other meds, stuff doctors usually don’t tell you, and more. :)


If you have any questions not answered here, please see the Crazymeds Topamax discussion board. I 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 I write these damn things. I’m frustrated enough as it is. 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.


Last modified on Wednesday, 26 March, 2014 at 21:36:57 by SomeMedCriticPage Author: JerodPooreDate created Tuesday, 11 January 2011 at 13:43:23

Topamax by JerodPoore is copyright © 2011 JerodPoore


Topamax, and all other drug names on this page and use throughout the site, are a trademark of someone else. Look on the the PI sheet or ask Google who the owner is. The way pharmaceutical companies buy each other and swap products like Monopoly™ real estate, the ownership of the trademark may have changed without my noticing.




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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.
The information on Crazymeds pertains to and is intended for adults. While some information about children and adolescents is occasionally presented (e.g. US FDA approvals), pediatric-specific data such as dosages, side effects, off-label applications, etc. are rarely included in the articles on drugs or discussed on the forum. If you are looking for information regarding meds for children you’ll have to go somewhere else.
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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.
All information on this site has been obtained through our personal experience and the experiences family, friends, what people have reported on various reputable sites all over teh intergoogles, the medications’ product information / summary of product characteristic (PI/SPC) sheets, and from sources that are referenced throughout the site. As such the information presented here is not intended as a substitute for real medical advice from your real doctor, just a compliment to it. You should never, ever, replace what a real doctor tells you with something from a website on the Internet. The farthest you should ever take it is getting a second opinion from another real doctor. Educate yourself - always read the PI/SPC sheet or patient information leaflet (PIL) that comes with your medications and never ever throw them away.
Crazymeds is not responsible for the content of sites we provide links to. We like them, or they’re paid advertisements, or they’re something else we think you should read to help you make an informed decision about a particular med. Sometimes they’re more than one of those things. But what’s on those sites is their business, not ours.
Very little information about visitors to this site is collected or saved. From time to time I look at search terms used and which pages they bring up in an effort to make the information I present more relevant. And the country of origin, just because I’m geeky like that. That’s about it. Depending on how you feel about Schrodinger, our privacy policy should either assuage or exacerbate your paranoia.
All brand names of the drugs listed in this site are the trademarks of the companies named on the PI/SPC sheet associated with the medication, sometimes on the pages about the drugs, even though those companies may have been acquired by other companies who may or may not be listed in this site by the time you read this. Or the rights to the drug were sold to another company. And any or all of the companies involved may have changed their names.
Crazymeds is optimized for the browser you’re not using on the platform you wish you had. Between you and me, it all looks a lot cleaner using Safari or Chrome, although more than half of the visitors to this site use either Safari or Internet Explorer, so I’m doing my best to make things look nice for IE as well. I’m using Firefox and running Windows 72. On a computer that sits on top of my desk. With a 23 inch monitor. Hey, at least you can make the text larger or smaller by clicking on the + or - buttons in the upper right hand corner. If you have Java enabled. Like 99% of the websites on the planet, Crazymeds is hosted on domain running an open source operating system with a variety of open source applications, including the software used to display what you’ve been reading. As such Crazymeds is not responsible for whatever weird shit your browser does or does not do when you read this site3.
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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?
[begin rant] I rent a dedicated server for Crazymeds. It’s sitting on a rack somewhere in Southern California along with a bunch of other servers that other people have rented. The hardware is identical, but no two machines have exactly the same operating systems. I don’t even need to see what is on any of the others to know this. If somebody got their server at the exact same time, with the exact same features as I did, I’m confident that there would be noticeable differences in some aspects of the operating systems. So what does this mean? For one thing it means that no two computers in the same office of a single company have the same operating system, and the techs can spend hours figuring out what the fuck the problem could be based on that alone. It also means that application software like IP board that runs the forum here has to have so many fucking user-configurable bells and whistles that even when I read the manual I can’t find every setting, or every location that every flag needs to be set in order for a feature to run the way I want it to run. And in the real world it means you can get an MBA not only with an emphasis on resource planning, but with an emphasis on using SAP - a piece of software so complex there are now college programs on how to use it. You might think, “But don’t people learn how to use Photoshop or Adobe Illustrator in college?” Sure, in order to create stuff. And in a way you’re creating stuff with SAP. But do you get a Bachelor of Fine Arts degree with an emphasis on Photoshop?
Back in the Big Iron Age the operating systems were proprietary, and every computer that took up an entire room with a raised floor and HVAC system, and had less storage and processing power than an iPhone, had the same operating system as every other one, give or take a release level. But when a company bought application software like SAP, they also got the source code, which was usually documented and written in a way to make it easy to modify the hell out of it. Why? Because accounting principles may be the same the world over, and tax laws the same across each country and state, but no two companies have the same format for their reports, invoices, purchase orders and so forth. Standards existed and were universally ignored. If something went wrong it went wrong the same way for everyone, and was easy to track down. People didn’t need to take a college course to learn how to use a piece of software.
I’m not against the open source concept entirely. Back then all the programmers read the same magazines, so we all had the same homebrew utilities. We even had a forerunner of QR Code to scan the longer source code. Software vendors and computer manufacturers sponsored conventions so we could, among other things, swap recipes for such add-ons and utilities. While those things would make our lives easier, they had nothing to do with critical functions of the operating system. Unless badly implemented they would rarely cause key application software to crash and burn. Whereas today, with open source everything, who the hell knows what could be responsible some part of a system failing. [/end rant]

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