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Topamax is the most commonly available brand name for the generic medication topiramate. Topamax is available in tablet form as well as in a sprinkle capsule; the latter is designed to be sprinkled on food for easier swallowing. A member of the sulfamate-substituted monosaccharide chemical class, Topamax is chemically related to the fruit sugar fructose. Like most other anticonvulsant medications, Topamax works by reducing abnormally high neural activity within the brain. Topamax and other forms of topiramate are initially prescribed in a low dosage; patients then increase their intake of the medication gradually until they are taking the full dosage required to treat their condition. If Topamax is discontinued, a similar procedure is required to prevent withdrawal symptoms.

Uses for Topamax

Topamax is an anticonvulsant medication used to treat a number of serious nervous system disorders, including the following:

  • Back pain, especially pain caused by pressure on nerves in the spinal column
  • Juvenile epilepsy
  • Neuropathic pain
  • Migraine
  • Alcoholism and other addictions
  • Borderline personality disorder
  • Bipolar disorder

For patients with chronic or severe back pain, Topamax can often provide significant relief and may be prescribed as an alternative to opiates and other potentially addictive pain medications.

Contraindications for Topamax

Patients who are allergic to monosaccharides should not use Topamax. Additionally, Topamax has been linked to birth defects when used during pregnancy. The medication may also reduce heat regulation, so children who take Topamax should be carefully monitored during hot weather or strenuous activity. Patients who have a history of kidney stones should note that Topamax increases the risk of these complications.

Known Drug Interactions

Topamax is known to interact with a wide range of drugs. Patients who have been prescribed Topamax should inform their physician if they are taking any of the following medications or substances:

  • Oral contraceptive pills
  • Magnesium salicylate
  • Seizure medications
  • Digoxin
  • Antidepressants
  • Tranquilizers
  • Antihistamines
  • Iron supplements
  • Carbonic anhydrase-based medications
  • Alcohol
  • Enzyme inducers

These medications have been shown to interact with Topamax. Depending on the drug, the effectiveness of one or both medications may be compromised or increased to an undesirable level.

Side Effects of Topamax

Topamax may cause minor side effects to include the following:

  • Drowsiness, fatigue and difficulty in focusing
  • Irritability and aggression
  • Gastrointestinal upsets, including heartburn, diarrhea, constipation or abdominal gas pains
  • Tremors and involuntary eye movements
  • Dandruff, unexplained hair loss or unwanted hair growth
  • Irregular skin tone
  • Thirst
  • Weight loss
  • Tinnitus
  • Irregular menstrual periods
  • Confusion and disorientation

These side effects are typically mild and go away on their own. Patients should consult their physician if these side effects persist or if they experience any of the following symptoms:

  • Loss of visual acuity, including double vision, blurred vision or pain in the eyes
  • Seizures
  • Slowed or irregular heartbeat
  • Chest pain
  • Fever and chills
  • Unconsciousness
  • Severe nausea and vomiting
  • Intense pain in the sides or back

These can be signs of a serious reaction to Topamax and may require immediate medical attention.

Many patients experience significant relief from their back pain on Topamax, especially when it is combined with other medications to provide a balanced approach. As always, consult a physician to determine the right course of treatment to manage severe or chronic back pain.