When was topamax approved for migraines

Interested in AAFP membership? Learn more. Topamax package insert. Titusville, N. Topiramate in migraine prevention: results of a large controlled trial. Arch Neurol. Topiramate for migraine prevention: a randomized controlled trial. Topiramate in migraine prophylaxis—results from a placebo-controlled trial with propranolol as an active control.

J Neurol. Chronicle E, Mulleners W. Anticonvulsant drugs for migraine prophylaxis. Cochrane Database Syst Rev. Effectiveness of high-dose riboflavin in migraine prophylaxis. A randomized controlled trial Neurology. Each update provides an independent review of a new medication by authors who have no financial association with the drug manufacturer.

The series coordinator is Allen F. Shaughnessy, Pharm. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.

Contact afpserv aafp. Want to use this article elsewhere? In women who take the drug during pregnancy, topiramate has been shown to increase the risk in offspring of cleft lip and palate. If the decision is made to use the medication by a woman of childbearing age, effective birth control should be used, the agency said in a release. Skip to main content.

Topiramate approved for migraine prevention in adolescents. Children who take Topamax are less likely than adults to have speech problems, slow reactions, and trouble concentrating. One possibly serious side effect is more common in children than in adults. Children taking Topamax are more likely than adults to have fever and reduced sweating. These problems can lead to hyperthermia high body temperature , which may need treatment in a hospital. If they sweat less than usual or develop a high temperature, call your doctor for advice.

You may wonder how often certain side effects occur with this drug or whether certain side effects pertain to it. As with most drugs, some people can have an allergic reaction after taking Topamax. A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:. Call your doctor right away if you have an allergic reaction to Topamax, as the reaction could become severe.

They may be able to suggest ways to help manage this side effect or suggest other treatment options. Topamax can raise the risk of developing kidney stones. In clinical studies , kidney stones were reported in an average of 1.

Topamax was compared with a placebo in some studies. But people treated with Topamax had 2 to 4 times more kidney stones than people in the general population. If you have any of these symptoms while taking Topamax, call your doctor right away. You may need treatment to help your body get rid of any kidney stones. This can reduce your risk for developing kidney stones. Kidney stones can be a sign that you have metabolic acidosis a high level of acid in your blood.

If you have metabolic acidosis, your doctor may lower your Topamax dose. Topamax may cause eye side effects. These may include vision changes, such as decreased or blurry vision, and secondary closed-angle glaucoma sudden raised pressure in your eye. Glaucoma can lead to permanent blindness if not treated. In clinical studies of people ages 16 years and older, they were given either Topamax or a placebo.

This was in addition to one or two other epilepsy drugs. Abnormal vision, such as blurry vision, occurred in:. In clinical studies of adults with migraine, they were given 50 milligrams mg or mg of Topamax, or a placebo. Blurry vision occurred in:. But eye side effects typically occur within the first month of Topamax treatment. If you have symptoms of eye side effects while taking Topamax, talk with your doctor.

They may refer you to an eye specialist , who can check the pressure in your eyes. If you have glaucoma, you may need treatment for it.

However, eye side effects usually get better after you stop taking Topamax. If you have eye side effects, your doctor will typically recommend that you stop taking Topamax and switch to a different treatment. Ideally, Topamax should be stopped gradually.

Your doctor will explain how to do this. Topamax can sometimes cause personality changes that affect the way people behave, react, feel, or interact with others. For example, the drug may cause agitation, aggression , or other behavior problems.

Topamax may also cause mood changes, such as anxiety , mood swings , and depression. In addition, the medication may raise your risk for suicidal thoughts or behaviors. All antiepileptic drugs medications used to treat seizures due to epilepsy are known to slightly raise the risk of suicidal thoughts and behaviors. Clinical studies looked at people taking an antiepileptic drug for any condition.

The people had about twice the risk of suicidal thoughts or behaviors than people taking a placebo. In these studies, suicidal behavior or thoughts occurred in:. These symptoms can include:. If you have any symptoms of new or worsening depression while taking Topamax, talk with your doctor right away. They can suggest ways to ease this condition. They may also recommend that you switch to a different medication.

If you need to stop taking Topamax, your doctor will explain how to taper off the drug gradually. However, weight gain has been reported with some anticonvulsant drugs that are in the same class as Topamax.

A drug class is a group of medications that work in a similar way. Topamax can cause weight loss. However, the drug may reduce your appetite, which may lead you to lose weight. This depended on the dosage and condition treated. One review of studies looked at the average weight loss in people who took Topamax. It also looked at how long it took them to lose weight when they took the drug. People who took Topamax for at least 4 months lost an average of But your doctor might recommend Topamax for preventing seizures or migraine if you would also benefit from weight loss.

You should take it as prescribed by your doctor for seizures or migraine. Note: Weight loss is an approved use for the brand-name medication Qsymia.

Qysmia contains topiramate the active drug in Topamax with another drug called phentermine. The drug is also approved for use in people who are overweight and have an increased risk of health problems. These can include conditions such as high blood pressure , high cholesterol , and type 2 diabetes. Typically, your doctor will start you on a low dose.

Your doctor will ultimately prescribe the smallest dose that provides the desired effect. The following information describes dosages that are commonly used or recommended.

However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs. The usual recommended dosage is 50 mg taken once in the morning and once in the evening. Your doctor will gradually increase your dosage to this level over the first 4 weeks of treatment. This allows your body to get used to the medication and helps reduce the frequency and severity of side effects. Topamax is used to treat epilepsy a condition that causes repeated seizures in certain situations.

The dosage of Topamax is gradually increased over the first few weeks of treatment. Topamax can be used on its own to treat partial-onset seizures and generalized tonic-clonic seizures. The usual recommended dosage for treating these types of seizures is mg twice per day. The drug should be taken once in the morning and once in the evening for a total of mg per day. This is the dosage for both adults and children ages 10 years and older.

Topamax can be used with other seizure medications to treat partial-onset seizures, generalized tonic-clonic seizures, and seizures linked to Lennox-Gastaut syndrome LGS. LGS is a rare form of childhood epilepsy that causes several different types of seizures. For the first week of treatment, the starting dosage is usually 25 mg to 50 mg per day.

After this, your doctor may increase your daily dosage by 25 mg to 50 mg each week until the recommended dosage is reached. The usual recommended dosages for treating these types of seizures in adults ages 17 years and older are:. The recommended dose per day is split into two equal doses.

One dose is taken in the morning and the other is taken in the evening. Topamax is used to treat certain seizures in children ages 2 years and older. The usual recommended dosage of Topamax in children ages 12 years and older is the same as it is for adults. For children ages 10 years and older, the usual recommended dosage of Topamax is the same as it is for adults.

Below is information for treating children ages 2 to 9 years. For the first week of treatment, the starting dosage is 25 milligrams mg taken every evening.

If your child tolerates this well, for the second week of treatment, their doctor may increase the dosage to 25 mg twice per day. This is a total of 50 mg daily. This will take place over the first few weeks until the recommended dose is reached. After this, their doctor may increase their daily dosage by 25 mg to 50 mg each week.

This is done until your child is at the minimum recommended dose for their body weight. This increase will continue until your child is at the maximum dose for their body weight. For children ages 2 to 9 years, the usual recommended dosage of Topamax is based on body weight as follows:. Children ages 17 years and older typically take the same dosage of Topamax as adults.

The following sections discuss the dosages for children ages 2 to 16 years. For the first week of treatment, the starting dose per day is usually about 1 milligram mg to 3 mg per kilogram kg of body weight. Topamax is typically taken as a single dose every evening. This allows their body to get used to the medication and helps reduce the frequency and severity of side effects.

The medication is split into two equal doses. The daily dose is increased until your child is at the minimum recommended dose for their body weight.

For children ages 2 to 16 years, the usual recommended daily dose is 5 mg to 9 mg per kg of body weight. The recommended daily dose is split into two equal doses. One dose is taken in the morning, and the other dose is taken in the evening. Take your next dose at your usual time. This can include setting an alarm on your phone or downloading a reminder app.

A kitchen timer can work, too. Topamax is meant to be used as a long-term treatment. You should avoid drinking alcohol with Topamax. Drinking alcohol during Topamax treatment can increase the frequency and severity of Topamax side effects, such as:. In serious cases, drinking alcohol with Topamax may lead to serious side effects. These may include slow, shallow breathing, loss of consciousness, coma, and in rare cases, death.

Topamax is more likely to make you feel sleepy, low in energy, or a bit dazed and confused. You may also have trouble with concentration, memory, or speech while taking it. Topamax has a half-life of about 21 hours.

The half-life of a drug is the time it takes for the amount of the drug in your body to fall by half. It takes about five half-lives for a drug to be almost completely removed from your body. So for Topamax, most of the drug will be flushed out of your system within about 5 days after you stop taking it. Controlled substances are drugs that have certain effects that give them a high potential for being misused.

They also have a high risk of leading to drug dependence. Because of these risks, there are special rules about how controlled substances are prescribed and dispensed. Mood stabilizers are drugs that help prevent extreme changes in mood, such as those that occur with bipolar disorder. People with bipolar disorder typically have episodes of depression and episodes of mania. Mania is a mood disorder that gives you an unnatural feeling of physical and mental energy. Several anticonvulsant medications also work as mood stabilizers in people with bipolar disorder.

Topamax, which is an anticonvulsant medication, is sometimes used in this way. Anticonvulsants are also called antiepileptic drugs. Anticonvulsants are mainly used to treat epilepsy a condition that causes repeated seizures.

These include migraine and nerve pain. However, once Topamax controls your condition, you will need to keep taking it to continue to prevent seizures or migraine. If you stop taking Topamax, your seizures or migraine headaches may happen more often. They could also become more severe. Sometimes people without epilepsy have had seizures after suddenly stopping Topamax. If you and your doctor decide to stop treatment, you may need to stop taking Topamax gradually.

This can help reduce your risk for seizures. Topamax can interact with several other medications. 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.