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Topamax affects the activity of the neurotransmitters, which relay signals between the nerve cells. The drug exerts a “stabilizing” effect on the central nervous system and helps have more control over neurological disorders. As a result of Topamaxaction, the overall functioning of the body improves.

Prescribing Information

Topamax has several different uses. Topamax sprinkle capsules and tablets are used for:

  • Prophylaxis of migraine headaches only in adult patients.
  • Mono or adjunctive therapy for epilepsy (seizures) in patients older than 6 and 2 years, respectively.

Topamax begins to affect the activity of chemicals in the brain immediately after the start of treatment. Yet, before patient has any noticeable improvements in neurological disorders, he may need to take pills within 10-14 days.

If Topamax is used in combination with other drugs, the improvement of the epilepsy symptoms can be noticed within a shorter period of time. If no improvements manifest in the first few weeks, do not worry. A delay in response to Topamax is normal, especially if low doses of anticonvulsant drug are used.


The course of treatment for migraine in adults usually begins with the use of the lowest effective Topamax dose of 25 mg. Titration (dose change) should occur slowly, at regular intervals (usually 1-week intervals).

Topamax is usually taken in 2 separate doses. Some patients may experience a benefit of using small, single daily doses of Topamax. High doses are recommended to divide into two intakes. The dose for children depends on the weight and age of the patient.

The recommended total daily dose of Topamax for the treatment of epilepsy in adults is 100-200 mg. If the disease is poorly treatable, the daily dose can be gradually increased to 1000 mg, yet the risks of side effects increase, if this is the case.

Topamax dose that is usually used in the prophylaxis treatment for migraine amounts to 50 mg, twice daily. If the “stabilizing” effect on the central nervous system is insufficient, the daily dose can be increased to 200 mg.


Topamax can be taken with other drugs, but only if their action does not interfere with each other. If the patient plans to take Topamax with any prescription or over-the-counter drugs, it is best to consult a doctor or pharmacist, to see if they are safe to use.

Topamax can interact with various medications, like neurotropic and psychotropic agents, anti-anxiety drugs, birth control pills or antidepressants. Do not take antiepilepsy drugs with alcohol, since it leads to an increased risk of untoward medical occurrence.

Side effects

The most common side effects of Topamax are related to the CNS and include drowsiness, insomnia, decreased appetite, weight loss, memory impairment, fatigue, loss of coordination, nausea, diarrhea, skin tingling or motor speech disorder.

The list of rare and very rare side effects of Topamax includes a decrease in the level of potassium in the blood, increased appetite, neutropenia, panic attacks, hyperaesthesia, eye movement disorder, erection problems, allergic reaction or allergy aggravation.


If you give Topamax to children or take this medication yourself, make sure that recommended doses are taken every day at the same time. Try linking the use of this anticonvulsant drug to something that you do every day (for example, have breakfast). This will help you not forget to take a dose.

You can share information about Topamax with your family members or close people to help them understand your treatment options. If side effects manifest or you have any questions about Topamax, talk with the nurse, doctor or pharmacist.