Still, some doctors may choose to prescribe Topamax off label. Your doctor may decide to do this if several other antidepressant or mood-stabilizing drugs fail to control your symptoms. Since one of the side effects of Topamax is weight loss, a doctor may also decide to prescribe Topamax alongside another antidepressant as an adjunctive therapy to help offset any weight gain that may have been caused by the antidepressant.
Mahmood S, et al. Effect of topiramate on weight gain in patients receiving atypical antipsychotic agents. There have been a few reports of Topamax causing or worsening depression in people taking it for other conditions, such as seizures, migraines, or bipolar disorder. Klufas A, et al. Letters to the editor: Topiramate-Induced Depression. About 1 in every people who took anticonvulsants like Topamax during clinical studies became suicidal.
Topamax topiramate medication guide. Topamax is a prescription drug that belongs to a class of drugs called anticonvulsants or antiepileptic drugs AEDs. Topamax tablets come as 25 milligrams mg , 50 mg, mg, and mg round tablets that are taken whole by mouth. The drug also comes in sprinkle capsules that can be broken open and sprinkled onto soft food. Topamax is thought to decrease abnormal excitement in the brain. GABA is involved in the excitability of the nervous system. Problems with the GABA system has also been thought to play a role in the development of psychiatric disorders, including anxiety and depression.
Cryan JF, et al. GABAB receptors and depression. Current status. Topamax can cause harm to the fetus. Infants exposed to Topamax in utero have an increased risk of cleft lip, cleft palate, and low weight. In the FDA approved Topamax for the treatment of partial onset or primary generalized tonic-clonic seizures and for people with seizures associated with Lennox-Gastaut syndrome.
Topiramate was also approved in for use in combination with another drug called phentermine for weight loss. This product goes by the brand name Qsymia. Vivus Inc. Topiramate is also used to prevent migraine headaches but not to relieve the pain of migraine headaches when they occur.
Topiramate is in a class of medications called anticonvulsants. It works by decreasing abnormal excitement in the brain. Topiramate comes as a tablet, a sprinkle capsule capsule that contains small beads of medication that can be sprinkled on food , and an extended-release long-acting capsule to take by mouth.
The tablets and sprinkle capsules are usually taken with or without food once or twice a day. The extended-release capsules are usually taken with or without food once a day. Take topiramate at around the same time s every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take topiramate exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
There is another medication with a name similar to the brand name for topiramate. You should be sure that you receive topiramate and not the similar medication each time you fill your prescription.
Be sure that the prescription your doctor gives you is clear and easy to read. Talk to your pharmacist to be sure that you are given topiramate. If you think you were given the wrong medication, talk to your pharmacist. Do not take any medication unless you are certain it is the medication that your doctor prescribed.
Topiramate tablets have a bitter taste so you should swallow them whole. It is especially important that you not take topiramate tablets that have been broken for any length of time because tablets that are broken may lose their effectiveness over time. The sprinkle and extended-release capsules Qudexy XR brand only may be swallowed whole or opened and poured over soft food.
Swallow extended-release capsules Trokendi XR brand only whole; do not split, chew, or sprinkle on food. Your doctor will probably start you on a low dose of topiramate and gradually increase your dose, not more than once every week.
Topiramate may control your seizures or migraines but will not cure your condition. Continue to take topiramate even if you feel well. Do not stop taking topiramate without talking to your doctor, even if you experience side effects such as unusual changes in behavior or mood.
If you suddenly stop taking topiramate, you may have severe seizures, even if you have not had seizures in the past. Your doctor will probably decrease your dose gradually.
Your doctor or pharmacist will give you the manufacturer's patient information sheet Medication Guide when you begin treatment with topiramate and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions.
Topiramate is also used for the management of alcohol dependence. Talk to your doctor about the risks of using this medication for your condition. This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information. Talk to your doctor about increasing the amount of food you eat if you lose weight while you are taking topiramate.
Talk to your doctor before changing your diet or beginning any type of weight loss program. Do not follow a ketogenic diet a high-fat, low-carbohydrate diet used to control seizures or any other high-fat, low-carbohydrate diet, such as the Atkins diet, while you are taking this medication.
If you are taking topiramate tablets or sprinkle capsules, take the missed dose as soon as you remember it. It can also interact with certain foods. Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works.
Other interactions can increase side effects or make them more severe. Below are examples of medications that can interact with Topamax. Before taking Topamax, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use.
Sharing this information can help you avoid potential interactions. If you have questions about drug interactions that may affect you, ask your doctor or pharmacist. Topamax can make birth control drugs that contain estrogen less effective at preventing pregnancy. Topamax treatment can also make certain birth control medications less effective at preventing pregnancy. These include:.
If you use birth control that contains estrogen, your doctor may recommend switching to a different type of birth control medication while you take Topamax. Taking Topamax with phenytoin Dilantin or carbamazepine Tegretol can lower the level of Topamax in your blood.
This could make Topamax less effective at preventing seizures or migraine headaches. If you need to take Topamax with phenytoin or carbamazepine, your doctor may prescribe a higher dosage of Topamax. This should increase the chances that the drug works for you.
If you need to take Topamax with valproic acid, your doctor may recommend blood tests. These will monitor the amount of ammonia in your blood. Taking Topamax with drugs called carbonic anhydrase inhibitors can raise your risk for a side effect called metabolic acidosis a high level of acid in your blood. Metabolic acidosis can also raise your risk for kidney stones. If you need to take one of these drugs with Topamax, you may need more frequent blood tests than usual.
These tests will check the level of acid in your blood. Central nervous system CNS depressants are medications that slow down activity in your central nervous system brain and spinal cord. These medications typically cause you to feel drowsy and less alert. But in serious cases, they can also cause slow, shallow breathing , loss of consciousness , coma , and in rare cases, death.
There have been no studies involving people who took Topamax with a CNS depressant. However, taking the two drugs together could raise your risk for the side effects mentioned above. For this reason, you should avoid CNS depressants while taking Topamax. These drugs can sometimes cause reduced sweating. Topamax can also reduce sweating. Therefore, taking Topamax with anticholinergic drugs could raise your risk for overheating and hyperthermia high body temperature , especially in hot weather.
Examples of anticholinergic drugs that could raise your risk for hyperthermia with Topamax include:. If you need to take one of these drugs, talk with your doctor about whether Topamax is right for you. Hydrochlorothiazide Microzide is a diuretic medication used to treat high blood pressure. Taking Topamax with hydrochlorothiazide may increase the level of Topamax in your blood.
However, your doctor may prescribe a lower dose of Topamax if you need to take hydrochlorothiazide as well. Pioglitazone Actos is a medication for type 2 diabetes. Taking Topamax with pioglitazone may decrease the level of pioglitazone in your blood.
However, if you need to take pioglitazone with Topamax, your doctor may monitor your blood sugar more often. This is to check that pioglitazone is still working you. Lithium Lithobid is a medication used for certain psychiatric illnesses, such as bipolar disorder and severe depression. Taking high doses of Topamax with lithium may increase the level of lithium in your blood.
This could raise your risk for lithium side effects. These include slurred speech, memory problems, kidney failure , and muscle tremors or twitches. A high lithium level can be serious. If you need to take Topamax with lithium, your doctor may order more frequent blood tests than usual.
These tests will check your lithium level. Your doctor may need to adjust the doses of your medications as needed. Taking Topamax with amitriptyline can increase the level of amitriptyline in your blood. This could raise your risk for amitriptyline side effects. These side effects include drowsiness, dizziness, irregular heartbeats , and seizures. If you need to take Topamax with amitriptyline, tell your doctor if you have any new side effects. Also, be sure to tell them if any side effects become more severe or occur more often.
Your doctor may adjust the doses of your medications as needed. However, you should still check with your doctor or pharmacist before using any of these products while taking Topamax.
A ketogenic diet is low in carbohydrates and protein , and high in fat. This is a high level of acid in your blood. If not treated, metabolic acidosis can raise your risk for kidney stones and weakening of your bones. Metabolic acidosis can also increase the risk of reduced growth in children. You should avoid following a ketogenic diet while taking Topamax to lower your risk for these side effects. Note: For some people, following a ketogenic diet can reduce the number of seizures they have.
However, as with several other anticonvulsant drugs, Topamax also helps prevent migraine headaches. Epilepsy and migraine are both neurological conditions.
With epilepsy, you have seizures. With migraine, you have headaches, among other symptoms. But the conditions are considered to be linked , and many people have epilepsy and migraine together. But with both conditions, it seems that nerve cells in your brain are oversensitive to certain triggers, such as flickering lights or hormones.
The trigger causes electrical signals to build up in the nerve cells in your brain. This causes them to fire inappropriate signals to other nerve cells. These nerve cells then pass on signals to other parts of your body. The increased electrical signaling can lead to a seizure in people with epilepsy. In people with migraine, it can lead to auras and headaches.
Topamax has several effects on the nerve cells in your brain. One is that the drug blocks sodium channels tiny openings through which sodium moves through your cells. This prevents excessive electrical signals from building up in the nerve cells. As a result, the nerve cells stop firing inappropriate or excessive signals. In addition, Topamax affects two neurotransmitters.
Neurotransmitters are natural body chemicals that help pass signals between nerve cells. These neurotransmitters are called gamma-aminobutyric acid GABA and glutamate. The neurotransmitters also help pass signals between nerve cells and other cells in your body. GABA reduces nerve signaling, causing fewer signals to be sent. Glutamate stimulates nerve signaling, causing more signals to be sent. Topamax increases the effect of GABA and blocks the effect of glutamate.
This helps calm nerve activity in your brain. The actions of Topamax help prevent the nerve cells in your brain from sending inappropriate signals that lead to seizures or migraine. Topamax starts working within a couple of hours after you start taking it. However, when you start treatment, your dose is increased slowly over a few weeks.
Therefore, it may take a few weeks before the medication level builds up enough for you to notice your seizures or migraine easing. Using more than the recommended dosage of Topamax can lead to serious side effects. Do not use more Topamax than your doctor recommends. You can also call the American Association of Poison Control Centers at or use their online tool. But if your symptoms are severe, call or your local emergency number, or go to the nearest emergency room right away.
Topamax can harm a fetus if taken during pregnancy. Babies who are SGA can have a lower birth weight, length, and head size than expected. Babies are more likely to be SGA when born to females who took a high dose of Topamax or took Topamax throughout their pregnancy. Pregnancy studies in the United States looked at babies who were exposed to topiramate the active ingredient in Topamax in the first 3 months of pregnancy.
The studies showed that 1. In comparison, oral clefts occurred in 0. These studies also showed that, in the U. In comparison, 5. Other medications may be more suitable for you. This registry monitors and records birth defects or changes affecting babies of females who took antiepileptic drugs , such as Topamax, while pregnant.
The registry helps healthcare professionals collect information about the safety of drugs such as Topamax during pregnancy. This can help you make informed decisions about the treatments you take during pregnancy.
You can register by visiting the program website or calling Note: Sex and gender exist on spectrums. Females using Topamax should use an effective method of birth control to help prevent pregnancy. However, Topamax can make birth control drugs that contain estrogen less effective at preventing pregnancy.
If you use birth control that contains estrogen , your doctor may recommend switching to a different type of contraception. If you have questions about your birth control needs, talk with your doctor.
Topamax can pass into breast milk. Sleepiness and diarrhea have been reported in children breastfed by females taking Topamax.
Other drugs are available that can treat your condition. Some may be a better fit for you than others. They can tell you about other medications that may work well for you. Note: Some of the drugs listed here are used off-label to treat these specific conditions. Examples of other drugs that may be used to prevent migraine headaches include:.
Examples of other drugs that may be used to treat seizures include:. As with all medications, the cost of Topamax can vary. To find current prices for Topamax tablets or other forms in your area, check out GoodRx. The cost you find on GoodRx. Before approving coverage for Topamax, your insurance company may require you to get prior authorization.
This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered. If you need financial support to pay for Topamax, or if you need help understanding your insurance coverage, help is available.
Janssen Pharmaceuticals, Inc. Topamax is available in a generic form called topiramate. And generics tend to cost less than brand-name drugs. To find out how the cost of topiramate compares to the cost of Topamax, visit GoodRx. They may have a preference for one version or the other.
Topamax comes in two different forms: a tablet that you swallow and a sprinkle capsule. The capsule can be swallowed whole or opened to sprinkle on a spoonful of soft food and swallowed.
Some people may take Topamax once every evening for the first week of treatment. After this, most people will usually take Topamax twice per day.
The best time of day to take Topamax is once every morning and once every evening. Try to take your dose at roughly the same time or times each day.
You should not crush, split, or chew Topamax tablets, as they have a very bitter taste. These tablets should be swallowed whole. If you take Topamax sprinkle capsules, you should swallow them whole. But if you have trouble swallowing them, you can split them open. Before taking Topamax, talk with your doctor about your health history. There are no contraindications to Topamax. Contraindications are conditions or factors that would prevent you from taking the medication.
But Topamax may not be right for you if you have certain medical conditions or other factors affecting your health. Depression or suicidal thoughts. Topamax is a type of drug called an anticonvulsant. Like all anticonvulsant drugs,Topamax can raise your risk for suicidal thoughts and behaviors.
Topamax can sometimes cause secondary closed-angle glaucoma sudden increase in the pressure in your eye. If you have glaucoma , or have had glaucoma in the past, talk with your doctor about whether Topamax is right for you. Lung or breathing problems.
Topamax can sometimes cause a side effect called metabolic acidosis , which is a high level of acid in your blood. Severe lung or breathing problems, such as COPD or asthma, can also increase the level of acid in your blood. If you have lung or breathing problems, you could have a raised risk for metabolic acidosis with Topamax.
Talk with your doctor about whether Topamax is right for you. If you take Topamax, you may need extra blood tests during treatment to check that the level of acid in your blood is safe. Kidney disease.
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