The Fda Black Box On Topamax
According to the FDA and their listed label update in 2014, Topomax includes a black-box warning that has the following known adverse effects:
According to the label, Topamax is only indicated for seizures as a secondary medication in support of a primary kind and for migraines and nothing else . Yet, I see people being prescribed this drug for all types of off-label use that are unrelated to either seizures or migraines. The large migraine group I run on Facebook grown to over 4000 migraineurs in the past two years.
Because I have found that Topamax is the #1 prescribed medicine to migraineurs when they join the group in despair and hopelessness, I have decided to designate Topamax also as the #1 medicine discussed on the series titled drugs of shame. This is apt because it affects the neurotransmitters and thereby puts the whole hormonal structure of the body in chaos.
Serious Side Effects Of Topamax
There are also serious side effects to be aware of when taking Topamax. These side effects usually require hospitalization or medical help, and may result in permanent injury or be life-threatening.
- Metabolic acidosis
- Excess ammonia in the blood
- New or worsening depression, anxiety, or suicidal thoughts/behaviors
- Sudden withdrawal seizures
Illnesses Or Conditions For Which Topamax Is Prescribed
I would like to add a 10th to that: I have broken a nailcan I get Topamax?
Honestly, off-label prescribing has gone too far! Does Topamax really treat so many disparate conditions that doctors prescribe it for everything, even when it is not FDA approved for these conditions? I must add that Topamax is one of the most dangerous drugs in the prescription market today. Not only is it a diet pill made from sugar derivatives but it uses two dangerous methods to achieve what several classes of drugs normally do separately and thus, with one medicine it affects and potentially damages the two circuits that are critical for brain function. Topamax and in time release Trokendi XR) is important to discuss because it was initially formulated as a diet pill. Yet over 50% of the new members who join my migraine group arrive with Topamax on their prescription list.
Evidence is also accumulating that Topamax can cause brain damage 4. Personally, I have heard of many cases where it in fact has done just that.
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Can Topamax Be Taken For Nerve Pain If So Whats The Dosage For This Use
It depends. Topamax isnt approved for nerve pain or trigeminal neuralgia. Theres no known maximum dosage for nerve pain since the drug isnt approved for this use.
However, Topamax may be prescribed off-label for treating nerve pain, such as trigeminal neuralgia. In small studies , topiramate has been shown to treat trigeminal neuralgia in people whove tried other drugs and still had symptoms.
If you have questions about treatment for nerve pain or off-label uses of Topamax, talk with your doctor.
How To Use Topamax
Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking topiramate and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth with or without food as directed by your doctor, usually twice daily. To prevent kidney stones from forming, drink plenty of liquids while taking this medication unless your doctor instructs you otherwise.
If you are using the tablet form of this medication, swallow the tablets whole since breaking them may leave a bitter taste.
If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.
Dosage is based on your medical condition and response to treatment. For children, the dosage is also based on weight. Your doctor will gradually increase your dose to reduce your risk of side effects. For some conditions, you may start treatment with topiramate once daily at bedtime and slowly increase your dose to twice a day. It may take several weeks or months to reach the best dose for you and to get the full benefit from this medication.
Tell your doctor if your condition persists or if it worsens.
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What To Ask Your Doctor
Topamax is used to treat epilepsy and to prevent migraine headaches.
Mild side effects from Topamax are common. But Topamax can also cause serious side effects in some people, especially at higher doses.
If you have questions about side effects from Topamax, talk with your doctor or pharmacist. Below are a few questions you may want to ask:
- If I have side effects from Topamax, will I need to take a lower dose of the drug?
- Are there any side effects of Topamax that I should tell you about right away?
- How should I manage side effects I may have from Topamax?
If you have migraine, consider signing up for Healthlines online newsletter. Youll get first-hand stories from people living with this condition as well as tips for managing symptoms.
What Happens With Epilepsy And Migraine
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.
The causes of epilepsy and migraine arent fully understood. 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.
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Whats Topamaxs Drug Classification
Topamax belongs to a class of drugs called anticonvulsants. Anticonvulsants are also called antiepileptic drugs.
Anticonvulsants are mainly used to treat epilepsy . But many drugs in this class, including Topamax, are also effective for other conditions that dont involve seizures. These include migraine and nerve pain.
If Topiramate Has So Little Evidence Supporting Its Use Why Should Anyone Prescribe It Over An Older Drug That Has More Research Showing Its Effectiveness
First of all, Topiramate generally has a better side effect profile than those older drugs. Some patients find that older mood stabilizers have side effects that are too dangerous or impact their lives too much.Second of all, many patients find that the older drugs do not control their disorders, while Topiramate does. That makes it the only effective known remedy for them.Lastly, topirmate is so far the only psychopharmacologic agent that appears to have an effect in providing relief for PTSD symptoms. These symptoms can be extremely debilitating.
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How Should This Medicine Be Used
Phentermine and topiramate come as extended-release capsules to take by mouth. The medication is usually taken with or without food once a day in the morning. This medication may cause difficulty falling asleep or staying asleep if it is taken in the evening. Take phentermine and topiramate at around the same time 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 phentermine and topiramate exactly as directed.
Your doctor will probably start you on a low dose of phentermine and topiramate and increase your dose after 14 days. After you take this dose for 12 weeks, your doctor will check to see how much weight you have lost. If you have not lost a certain amount of weight, your doctor may tell you to stop taking phentermine and topiramate or may increase your dose and then increase it again after 14 days. After you take the new dose for 12 weeks, your doctor will check to see how much weight you have lost. If you have not lost a certain amount of weight, it is not likely that you will benefit from taking phentermine and topiramate, so your doctor will probably tell you to stop taking the medication.
Phentermine and topiramate may be habit forming. Do not take a larger dose, take it more often, or take it for a longer period of time than prescribed by your doctor.
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I had a rare side effect while taking this drug. I read online and many others have experienced this too. It gave me major cystic acne all over my face and left me with terrible red scars. I am slightly overweight so I did like that I was losing weight while on topamax. However due to the acne I will have to stop. Didnt notice it helping my mood, used also for alcohol cravings which it did help with. Hoping the acne goes away once I stop the drug…be careful what you put in your body.
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Topamax Withdrawal And Dependence
There havent been studies on whether Topamax can cause drug dependence.
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.
You shouldnt stop taking Topamax without first talking to your doctor. 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. Your doctor will explain how to do this.
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Well when I first had my first dose I benefit the drugs effects I was in a manic and I was going to have a seizure I had 100 mgs 20 minutes later I felled fantastic. After that I was talking 100mgs a day and after 3 weeks I feel even better my mood swings have gone and my depression and very calm and no brain zaps I get from my Eplepcy. Its a wonder drug for me I could not be with out it and I take olanzapine as well. If you are a ex amphetamine user this is for you trust me.
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Suicidal Thoughts Or Behavior
- Risk factors: History of depression
Topiramate can raise the risk of suicidal thoughts or behavior. Watch for worsening depression or any unusual changes in mood or behavior, especially during the first few months of treatment or when the dose changes. Be aware of changes in behavior that could lead to suicidal thoughts or depression, and report anything concerning to your provider right away.
Topamax To Prevent Migraine Headaches
Topamax is FDA-approved to help prevent migraine headaches in adults and in children ages 12 years and older.
Migraine is a condition that can cause headaches that are intense, throbbing, and long-lasting. Many people also have nausea, vomiting, and increased sensitivity to light and sound with a migraine episode. Some people also have sensory symptoms, called an aura, before or during the migraine episode.
The aura may cause you to see flashing lights or zigzags, or have blind spots in your vision. The aura can also cause tingling feelings or problems with speech. After a migraine episode, many people feel wiped out, tired, or irritable for up to 2 days.
Migraine episodes can be treated with medications that help relieve the symptoms. But the episodes can be disabling and can often affect your ability to perform your usual activities.
If you have migraine episodes that happen more than once a week or are severe, talk with your doctor. Theyll likely recommend medication to help prevent migraine. Your doctor may also suggest medication to help prevent migraine if drugs for treating migraine arent suitable or dont work for you.
Effectiveness for preventing migraine headaches
Topamax was found effective in preventing migraine headaches in clinical studies.
Two studies involved adults who had an average of 5.5 migraine headaches every month. They took Topamax or a placebo every day for 26 weeks. People who took:
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Important To Remember For All Medications
Overdosing is when you take more than your prescribed dose. Never overdose. If you believe an overdose has occurred visit the emergency department of your hospital. Take the medication container and pack with you even if its empty. Better to be safe than sorry.
The medication prescribed to you is only for you. Never share it with others who you believe have a similar condition. Your specific treatment may cause serious issues with others who do not share the same health profile, history or who are using other medications.
If you are having an operation or dental treatment, tell the practitioner what treatments you are currently taking.
Out of date medications should be disposed and can have unintended consequences if taken.
If you have questions about your treatment ask your pharmacist or doctor.
Never change or stop your treatment or dosage without first consulting your doctor.
Higher Level Of Acid In Blood
- Risk factors: Kidney disease | Severe breathing disorders | Diarrhea | Keto diet | Status epilepticus
In some rare cases, topiramate can raise the level of acid in your blood . If not treated in time, it can cause kidney stones, or weaken your bones and make them more likely to fracture . In children, it may affect their growth. Other symptoms of metabolic acidosis include loss of appetite, fatigue, and irregular heartbeat. Your provider might do regular blood tests to make sure the level of acid in your blood is not high.
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What Should I Know About Storage And Disposal Of This Medication
Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture .
Store phentermine and topiramate in a safe place so that no one else can take it accidentally or on purpose. Keep track of how many capsules are left so you will know if any are missing.
Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website for more information if you do not have access to a take-back program.
It is important to keep all medication out of sight and reach of children as many containers are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location â one that is up and away and out of their sight and reach.
Common Side Effects Of Topamax
Most of the side effects associated with Topamax are considered mild to moderate. Many will disappear or subside as you adjust to the medication. If you experience any of these symptoms, notify your doctor immediately because they might indicate more severe side effects. These are the most common Topamax side effects, according to the manufacturer:
- Loss of appetite, changes in taste, weight loss, stomach pain, and even anorexia
- GI side effects
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Pregnancy And Breastfeeding While Taking Topamax
Below we provide information about Topamax and pregnancy and breastfeeding.
Topamax and pregnancy
It may not be safe to take Topamax while pregnant. If taken during pregnancy, the drug can cause side effects in children. These can include cleft palate and cleft lip, and being smaller than usual for their age.
If youre pregnant or planning a pregnancy, talk with your doctor before starting Topamax. They may recommend a different drug for your condition.
If you take Topamax during pregnancy, consider enrolling in the drugs pregnancy registry. Pregnancy registries collect information about the drugs effects when used during pregnancy. This helps researchers understand the risks of using Topamax during pregnancy, which can help others make decisions about their treatment.
To enroll in the North American Antiepileptic Drug Pregnancy Registry, visit the registrys site. Or call 888-233-2334.
Topamax and breastfeeding
It may not be safe to use Topamax while breastfeeding. If taken while breastfeeding, Topamax may pass into breast milk. The drug may also cause a breastfed child to have diarrhea and sleepiness.
Your doctor can talk with you about the risks and benefits of taking Topamax while breastfeeding.
Is Topamax A Mood Stabilizer
Topamax is sometimes used off-label* as a mood stabilizer in people with bipolar disorder. 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. However, theres not much evidence that Topamax is effective for this use. To read more about this, see the Topamax uses section above.
* Off-label drug use means using a drug for a purpose other than what its been approved for by the FDA.
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