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> Topamax Side Effects


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1.  About Side Effects

Potential side effects (adverse events in fancy pharmaceutical talk) are often used as a rationalization to not take a medication. Many people will stop taking an otherwise working drug because of one or more side effects that are relatively minor and/or often temporary. There may even be ways to counter or mitigate the problematic effects.

It all comes down to a very simple equation: which sucks less?

There is no perfect drug. If you keep switching meds in the hopes of finding something with no side effect, or irrelevant side effects that don’t bug you as much, you could wind up treatment-resistant, and a med that worked before may work not as well as it did the first time, if at all.

1.1  Side Effects All Crazymeds Have

No matter which neurological and/or psychiatric drug you take, you’ll probably get one or more of these side effects. These will usually be gone, or at least will diminish to the point where you barely notice it most of the time, within a week or two.

  • Headache
  • Drowsiness / fatigue - even when taking stimulants in some circumstances.
  • Insomnia, instead of or alternating with the drowsiness.
  • Nausea
  • Assorted other minor GI complaints (constipation, diarrhea, etc.)
  • Generally feeling spacey / out of it
    • Which can all add up to the ever-helpful ”flu-like symptoms” listed as an adverse event on the PI sheet of practically every medication on the planet used to treat almost any condition humans and other animals could have.
  • All crazy meds can, and probably will affect your dreams
as well. There is no way of telling if that will be good or bad, let alone if this side effect is permanent or temporary.

So don’t operate any heavy machinery and try to avoid driving the first couple of days. We always recommend1 starting a new med Friday night / Saturday morning (or whenever your day off is) so you have an idea of how it will affect you for the first week or two. Keep in mind: most side effects are usually temporary in nature.



2.  Topamax (topiramate) Typical Side Effects

Most everyone gets at least one or two of these
  • Memory loss.
  • Sleepiness, fatigue, and/or lethargy.
  • A pins & needles effect (paresthesia), usually in your extremities, and that usually goes away after a week or two. If it doesn’t go away after two weeks it may never go away. The paresthesia may or may not be constant.
    • Keep this in mind: Paresthesia is a good sign. At least if you’re taking Topamax for migraines. If your fingers2 are tingling, you’re way more likely to respond to Topamax than if they weren’t.
  • Sodas and other carbonated beverages will taste like ass.
  • Memory loss.
  • Weird words coming out in place of what you wrench to say or spoon (aphasia).
  • Word find problems, i.e. not being able to recall the names of people, things or, uh, you know, those thingies that are abstract…concepts! (dysnomia).
  • A general cognitive impairment that has earned this drug the nicknames “Stupamax” and “Dopamax.”
  • Shit, I’m sure I forgot one.

3.  Topamax (topiramate) Uncommon Side Effects

You may or may not get one or more of these, so don’t be surprised either way
  • Dry and/or itchy eyes along with assorted vision problems up to narrow-angle glaucoma. Don’t flip out over the glaucoma. It goes away after you stop taking Topamax, even if you go blind.
  • 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 vu or jamais vu. If you were experiencing one prior to taking Topamax be prepared to experience the other.
  • Full-body muscle aches that feel as if you were hit by a truck, or had a tonic-clonic seizure. Similar to Lamictal. 3

4.  Potentially Dangerous Side Effects of Topamax (topiramate)

If you have one or more of these, call your doctor ASAP. Or now. Or get the hell off of the Internet and go to the ER NOW!
  • Kidney stones and similar renal problems.
  • Decreased sweating (oligohidrosis) and increased body temperature (hyperthermia). Adolescents and children are more susceptible to this one.
  • Metabolic acidosis
  • Hyperammonemia (build-up of ammonia in your blood), with and without encephalopathy (doctorese for “my brain hurts”). This usually happens when:

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5.  Topamax Freaky Rare Side Effects

You won’t get these. Unless you already have and that’s why you’re here
  • Tongue paralysis
  • Neverending cough
  • Staghorn calculus. I’d like to know how you do calculus using antlers. “Calculus” is doctorese for “kidney stone” and similar problems that involve your squishy bits turning into rocks. “Staghorn” is your upper urinary tract. Staghorn calculus is painful, serious, and if you look at the pictures with this case report, rather gross.
  • Palinopsia and the Alice in Wonderland syndrome. So Topamax explains Sarah Palin?
    • Palinopsia is persistent after images, i.e. you keep seeing something you looked at when you look at something else. Read about one of our forum member’s experiences with Topamax-induced palinopsia. It was a temporary, albeit worrying, side effect.
    • Alice in Wonderland syndrome is when you perceive all or parts of your body as being very large (macropsia) or very small (micropsia). It is often a symptom of migraines and temporal lobe epilepsy, so it is often fixed by Topamax. As with all anticonvulsants, anything Topamax can fix is also a potential side effect. I still have an episode of macropsia now and then, due to epilepsy that affects my temporal lobes and other places (so it’s not officially temporal lobe epilepsy), but it happens far less often thanks to Topamax.

For all known side effects, see the Topamax (topiramate) full US prescribing information. Or really indulge your paranoia by reading every PI sheet in the world we can find.

Be very careful. Reading the PI sheet for a drug you haven’t been prescribed, or even discussed with your doctor, can often be an exercise in the fear of medications (pharmacophobia).

6.  Ways to Counter/Minimize/Deal with Some Side Effects of Topamax (topiramate)

Be sure to read the page on how to deal with side effects common to all crazy meds
  • A lot of people who get the full-body muscle ache have reported regular stretching (e.g. yoga) helps.
  • While Topamax usually works a lot better for certain things (e.g. ultradian rapid cycling) when you take it twice (or even three or four) times a day, if the sleepiness and/or fatigue are bad enough you can try taking all or most of your dosage at night.
  • Drink plenty of water.
  • For some of us weight loss is actually a bug and not a feature. Topamax is a crazy med that usually works as well, or nearly as well, the second time you take it as it did the first. Except you won’t lose any weight the second time around. Even if you do, it won’t be as much. So if weight loss is a serious problem for you, then taking a medication holiday for a couple of months should fix it. Although in my experience those of us who don’t need to lose weight are the ones who usually do, and you’ll probably be one of those people who still lose weight no matter how many times you stop taking Topamax and try it again latter.

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Pros & Cons, Interesting Stuff Your Doctor Didn’t Tell You | Topamax Index | Blackbox Warning & Noted Traits
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1 If you have the luxury of both a job and being able to cope with your symptoms not being dealt with for however many days you need to wait in order to do this. Read enough of this site and you can tell I live in a fantasy world.

2 Or your toes, or some other part of your body that wasn't being stimulated in any fashion other than as a side effect of Topamax.

3 As Topamax and Lamictal are both approved to treat Lennox-Gastaut syndrome, and are particularly good at dealing with atonic, or drop seizures, my guess is this side effect is a result of that. Sort of like how allergies are immune responses to germs that no longer exist, in that you get this side effect if you don't have atonic/drop seizures. So the next time you feel like bitching about this side effect, google Lennox-Gastaut syndrome imagine what your life would be like if your kid had that. Unless you're in pain most of the day, day after day, shut up and take your meds.


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 Tuesday, 24 September, 2013 at 19:19:17 by JerodPoorePage Author: JerodPooreDate created Tuesday, 11 January 2011 at 13:43:23

Topamax Side Effects 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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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.
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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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