The medication Topamax has been in the news off and on for some time. But what is it? Topamax (often misspelled as Topamax or Topomax) is an anticonvulsant that doctors prescribe for a variety of different conditions, from seizures to migraines to some eating disorders. It’s the side effects, though, that have made headlines. But just how serious are they? And if you’re already taking Topamax, what should you look out for?
In general, doctors will only prescribe medication if they believe that the positive aspects of the treatment outweigh any negatives. That said, it’s important to recognize when what you’re experiencing may be symptoms of something more serious. Like any medication, Topamax can cause side effects in some patients.
Some of these are serious, while others are merely annoying. And many patients experience no side effects at all. If you are or will be taking any medication, though, it’s important to know the side effects and to know when to contact your physician.
What is Topamax?
Topamax is the brand name for the anticonvulsant drug Topiramate. Qsymia is another name for Topiramate. Qsymia is marketed as a weight loss drug.
Why Do Doctors Prescribe It?
Doctors most commonly prescribe it for patients who experience certain kinds of seizures. They may also prescribe it to prevent, but not treat, migraines. Some doctors have also prescribed Topamax for Binge Eating Disorder.
Some of the controversies around this medication come from its off-label uses. Off-label prescription means using a drug to treat a condition that the drug is not approved to treat. Some off-label uses have included treatment for alcoholism, anxiety, and depression.
How Does It Work?
Every medication works on your body’s processes in different ways. Topomax works on neurotransmitters, that is, the chemicals that allow your brain to transfer signals between nerves and to different parts of your body.
Topomax prevents seizures by stabilizing electrical nerve activity in the brain. It does this in three ways.
First, it enhances a neurotransmitter called GABA, which calms nerves. Second, it decreases the action of another neurotransmitter, glutamate, which excites nerves.
Finally, it blocks sodium from entering nerve cells. Consequently, electrical signals don’t build up in the cells.
The cells don’t fire the rapid and repetitive signals that cause seizures those suffering from spinal muscular atrophy.
No one is quite sure how Topamax prevents migraines. This medication won’t stop a headache once it has started, but it will cut down the frequency and severity of the migraines.
Sometimes doctors will prescribe Topamax (under the name Qsymia) for weight loss. How does it help you to lose weight? First, it makes food taste less appealing. Also, it helps your body to burn calories faster. Finally, it decreases appetite.
Since 2004, the FDA has issued some warnings about dangerous side effects stemming from the use of Topamax.
In 2011, the FDA issued a warning that taking Topamax during pregnancy could increase the risk of cleft lip and cleft palate in babies. Drug shortages definitely overwhelm healthcare reasons.
According to studies, the risk was twenty-one times higher among mothers who had taken Topamax than among mothers who had not. Also, the FDA warned, Topamax can reduce the effectiveness of hormonal birth control.
Clinical trials showed that patients taking Topamax might experience suicidal thoughts. Not only that, but that these thoughts could begin immediately upon starting the medication, and persist for up to six months.
Four suicides occurred during the trials. In 2009, the FDA warned that anticonvulsant drugs, including Topamax, could cause suicidal thoughts.
In 2006 the FDA warned against several eye disorders that may occur as a result of taking Topamax. These include glaucoma, nystagmus, dry-eye, and nearsightedness. Many believe these problems to be the result of an allergic reaction to the sulfa component of the drug.
In 2004, the FDA issued a warning that Topamax may cause metabolic acidosis, that is, an increase of acidity in the blood. That can result in osteoporosis, rickets, or kidney stones. People suffering from diabetes must not take any of these.
The FDA statement also warned that Topamax could cause oligohydrosis, that is, a decrease in sweating that can be dangerous during exercise, as well as a dangerous increase in body temperature.
There have been numerous lawsuits against the manufacturers of Topamax. As a result, the manufacturer issued new warnings to physicians and consumers.
Following the FDA’s 2011 warning, a stream of lawsuits came from parents whose children had been born with severe cleft palates. Janssen Pharmaceuticals denied the allegations, but juries sided with the plaintiffs.
They found that Janssen Pharmaceuticals had failed to warn either doctors or consumers of this possible side effect. Consequently, doctors are now advised to carefully weigh the benefits of prescribing this medication to women of childbearing age.
Topamax Side Effects
If you’re taking or will take Topomax, what are the most common side effects you might experience? And which should concern you?
A good rule of thumb is that if a side effect is troublesome, that is, if it keeps you from functioning normally, you should tell your doctor. That particular side effect may or may not be serious, but your doctor may be able to give you advice about how to overcome it.
You should tell your doctor if you are experiencing side effects and they are getting worse. Also, you have to understand the dangers of immunotherapy and its derivatives.
Most importantly, know the signs of serious life- and health-threatening side effects, and if you experience them, tell your doctor immediately.
Side effects that more than 1 in 10 patients experience
These are the most common side effects, affecting 10 percent of patients or more. Some people report feeling drowsy, tired, or dizzy while taking Topamax.
Topamax may cause temporary changes to your digestive system. You may, for example, experience a bad taste in your mouth. You may also lose your appetite. Diarrhea is not uncommon. And you may lose weight while taking this medication. Inflammation of the nose and throat are common. You may experience a runny nose or a sore throat, as well.
Many people also experience tingling or “pins and needles” in their hands and feet.
Side effects that between 1 in 10 and 1 in 100 patients experience
Some side effects are a little less common than the ones described above, but still not unusual. While taking Topamax, some patients may also experience diarrhea, abdominal pain, constipation, or indigestion.
Additionally, some patients experience confusion. Some also have trouble concentrating or paying attention. Some report that their thought processes slow down. Patients may also experience memory problems, or other speech and language problems. It may also make you nervous. Some patients also experience loss of coordination. Anxiety and mood swings are also not uncommon.
Some sensory side effects may also occur, such as alteration in, or loss of senses of taste or touch. Ringing in the ears and double vision also occurs. Topomax causes tremors in some patients. Likewise, some patients experience twitching, muscle pain, or weakness. Finally, patients taking Topamax may also experience skin rashes, anemia, kidney stones, shortness of breath, and nosebleeds.
Rare but serious side effects
Like all medications, Topiramate can cause serious side effects in some patients. These are rare and unlikely. However, if you do experience these symptoms, contact your doctor immediately. Doctors often recommend drinking plenty of water while taking Topiramate.
That is to help prevent kidney stones. Kidney stones are buildups of minerals in your kidneys. They are painful and can be serious. If you experience severe pain in your back, side, groin, or abdomen, tell your doctor. Other symptoms of possible kidney stones include painful or frequent urination, blood in the urine, and chills.
A small number of people who take any anticonvulsant, including Topamax, may experience depression, mood swings, and suicidal thoughts. If you have thoughts of harming yourself while taking Topamax, you should tell your doctor right away.
Topamax can cause a rare but serious eye problem that, if untreated, can lead to blindness. If you experience sudden vision changes such as blurry vision, eye pain or redness, or decreased vision, it’s important to seek medical attention.
Notify your doctor right away if you experience unexplained fatigue, vomiting, or decreased alertness, especially if you are taking valproic acid (Depakote). These can be signs of a rare but serious metabolic problem that causes too much ammonia in the blood.
Allergic reactions to Topamax that require medical treatment are rare. However, they do occur. If you develop a rash, itching or swelling (especially in the face, tongue, or throat), severe dizziness, or breathing problems, get medical attention immediately.
Patients may also, rarely, experience rapid breathing, irregular heartbeat, a heartbeat that is too slow or too fast, bone pain, broken bones, loss of consciousness, and unusual bleeding or bruising. These are all serious side effects that your doctor needs to know about as soon as possible.
When To Contact Your Doctor
Remember, most doctors only prescribe medications if they believe the benefit is worth the side effects. But understanding which side effects are serious can save your life.
Serious side effects from Topamax are rare. Still, if you experience symptoms of any of the serious side effects listed above, seek medical attention right away. As for the more common side effects, notify your doctor if they get worse, interfere with your normal daily activities, or simply cause you concern.