Topamax Index | Brand and Generic Availability ›
Crazy Meds Comprehensive Topamax pages

This is our basic overview of Topamax (topiramate). Clicking on a “More…” link will take you to a page with greater detail. The Comprehensive Topamax pages contain all of the information from all of the “More…” pages, but with less explanatory material.

1.  Brand & Generic Names; Drug Class

US brand name:	Topamax
Generic name:	topiramate
What is Topamax (topiramate)?	Topamax (topiramate) is in the AntiepilepticDrugs/Anticonvulsants class of drugs.

More about Topamax’s generic availability, worldwide trade names, and more

2.  What is Topamax (topiramate) used for

2.1  US FDA approved treatment(s)

Epilepsy - by itself or with other meds, for adults & children. Migraines.

2.2  Popular off-label uses

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

More about Topamax approved & off-label uses

3.  When will Topamax (topiramate) start working?

3.1  How long until Topamax 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.

3.2  Will Topamax really work for what I have?

For migraines: Really good, which is probably why Ortho-McNeil is all about Topamax for migraines these days.
For epilepsy: pretty good.

More about how long until, and how well will Topamax work; and how Topamax compares with other drugs

4.  How to take and stop taking Topamax (topiramate)

4.1  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.

4.2  How to stop taking Topamax

Ortho-McNeil 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 discontinuing Topamax

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5.  Topamax’s (topiramate’s) pros and cons

5.1  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.

5.2  Cons

The promise of losing weight is oversold and often leads to disappointment. Topamax can make you dumber than a box of rocks.

5.3  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.
More of Topamax pros, cons, and interesting stuff

6.  Topamax (topiramate) side effects

6.1  Typical Topamax 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.”

6.2  Uncommon Topamax 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.

6.3  Freaky rare Topamax 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?
More about Topamax side effects

7.  What Topamax (topiramate) is best known for

Turning you into the stereotype of a supermodel: thin and stupid.
More about Topamax black box warnings, noted traits & effects

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8.  Topamax (topiramate) half-life & how long until Topamax clears your system

Half-life: 21 hours. Clearance: four to five days.
Drugs.com’s drug-drug and drug-food interaction checker
More about Topamax pharmacokinetics & noted drug-drug & drug-food interactions

9.  How Topamax (topiramate) works (the best current 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 about how Topamax works. AKA Topamax mechanism/method of action, or pharmacodynamics.

10.  Comments

Whether you call it 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.
More comments As if I didn’t go on long enough here.
Consumer/patient comments about & experiences with Topamax

11.  Discussion board, PI sheet and other allegedly useful links

Crazy Meds’ Topamax discussion board
Topamax’s Full US Prescribing Information / PI Sheet
Allegedly Useful Links. Mostly any official sites we could find for this med and PI sheets from countries other than the US.

Topamax Index | Brand and Generic Availability ›
Crazy Meds Comprehensive Topamax pages

Bibliography

Date created Tuesday, 11 January 2011 at 13:43:23 Page Author: Jerod Poore Last edited by: JerodPoore

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Topamax Basic Overview by Jerod Poore is copyright 2011 Jerod Poore

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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, and 2012 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 the following disclaimer, I’m usually cool with it.

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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.
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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 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 Crazy Meds. 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 the forerunner to 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]