Topamax, or topiramate, is an anticonvulsant, used either on its own or in combination with other anti-epileptic medications, to treat specific types of seizures. It's commonly used as a migraine prophylaxis, which means it doesn't relieve the pain of an acute attack but reduces the frequency and severity of migraines. Topamax is also used in psychiatry to treat mood disorders. Topamax has several serious side effects, and the benefits of its use should always be weighed carefully against the risks.
Cognitive Side Effects
Topiramate can cause cognitive dulling, with slowed thinking and memory problems. A prominent side effect is difficulty finding words. According to a study published in the "Journal of Clinical Neurology," patients on topiramate showed a significant impairment in verbal fluency and the ability to recall numbers and words. According to the National Institutes of Biotechnology Information, Topamax can cause a variety of neurological and psychiatric symptoms, including depression, irritability, aggressive behavior, confusion and nervousness.
Visual Side Effects
Topiramate can precipitate acute angle closure glaucoma. According to the Department of Health of the Australian Government, this side effect is rare. Symptoms include blurry vision, eye pain, nausea and headaches. Treatment includes immediate cessation of topiramate and management of the glaucoma. Blindness may occur.
Weight Loss
Topiramate may induce weight loss. Though the exact mechanism of weight loss is unknown, topiramate reduces appetite and can also decrease the sense of taste. It may also affect the metabolism. In a study published in the "Primary Care Companion to the Journal of Clinical Psychiatry", Topamax produced an average weight loss of 22 pounds in patients who were treated for psychiatric conditions. This side effect is often considered beneficial by patients.
Renal Effects
Topamax can lead to the formation of kidney stones, more often in men and in people who've had previous episodes of kidney stones. Symptoms include bloody urine and severe pain, typically in the flank. The pain tends to come in waves and is accompanied by sweating, nausea and vomiting. Drinking plenty of fluids can decrease the risk of stone formation, explains the National Institutes of Biotechnology Information.
References
- "Journal of Clinical Neurology"; Cognitive Effects of Low-Dose Topiramate Compared With Oxcarbazepine in Epilepsy Patients"; S.Y. Kim et al.; June 2006
- National Institutes of Biotechnology Information: Topiramate
- "Primary Care Companion Journal Clinical Psychiatry"; "Topiramate in Bipolar and Schizoaffective Disorders: Weight Loss and Efficacy"; Sanjay Gupta et al.; February 2003
- "Harrison's Principles of Internal Medicine"; Anthony S. Fauci et al.; 2009
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