What is it?
Topamax, or topirimate, is an anticonvulsant developed in the 1970’s and 80’s. It is now available in generic form in the US and Canada.
What are its uses?
Topamax is prescribed to prophylactically treat epilepsy as well as migraine. It is also being investigated as a treatment for various psychological disorders including bipolar disorder, borderline personality disorder, and alcoholism.
One of the more positive side effect of Topamax for some is weight loss, and in some cases it has been prescribed for that (though off label).
How does it help with migraines?
One hypothesis for the cause of migraine is vascular convulsion in the brain. There are other theories related to Topamax’s effect on certain neurotransmitters and other brain functions.
How effective is it for migraines?
Patients who see improvements from Topamax can see a significant reduction in migraine frequency, especially at higher doses.
What are the common side effects?
Topamax is marked by its unusual and sometimes severe side effects. The most notable being the common cognitive effects:
- Difficulty concentrating
- Confusion
- Difficulty with speech, in particular difficulty finding word
- Memory issues
- Depression
Besides the cognitive side effects, Topamax has other effects as well:
- Fatigue
- Weight loss, loss of appetite
- Dizziness
- Tiredness
- Tingling in the fingers and toes, paresthesia
When should you avoid it?
If you have a history of depression, especially associated with suicidal thoughts you may want to avoid Topamax. It is also not recommended for pregnant women.
Many people who try Topamax for management of migraines transition off of it once the cognitive effects become too disruptive to their daily life.
Always disclose your full medical history with your doctor, including mental health history, when discussing long-term treatments like this to avoid poor reactions or negative side effects.