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While many tend to disappear after the first 8 weeks of therapy, it's still important to report them to your doctor. Check with your doctor if any of these most COMMON side effects persist or become bothersome: Abnormal skin sensations (numbness or tingling, decreased sensitivity), abnormal walking, agitation or aggression, appetite loss, back pain, breast pain, change in speech, clumsiness, coordination decreased, confusion, constipation, decreased hearing, decreased sweating, depression, diarrhea, difficulty with concentration or attention, dizziness, drowsiness, dry mouth, fatigue, flu-like symptoms, hot flushes, injury, indigestion, infection, itching, leg pain;menstrual disorder;mood swings, muscle pain or contractions, nausea, nervousness or anxiety, runny nose, saliva increased, sex drive decreased, sinus swelling, skin disorder, stomach pain or ache, strange taste, sore throat, thinking problems, thirst, tremor, unstable emotions, vomiting, weakness.

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Topamax Missed Dose

If it is time for another prescribed dose, skip the one that you have missed and proceed with your regular dosing schedule. You should stop your treatment with Topamax and alert your personal physician at once if you experience any of these severe and dangerous side effects: abnormal vision loss, pain behind or around your eyes; increased thirst, dry mouth, drowsiness, confusion, increased body temperature, decreased sweating, and dry, hot skin; vomiting, nausea, muscle weakness or pain, increased urination, feeling light-headed, fainting, fast heart rate, or seizure; severe back pain, difficult or painful urination.

Warnings

Symptoms typically occur within 1 month of initiating Topamax therapy. Patients, especially pediatric patients, treated with Topamax should be monitored closely for evidence of decreased sweating and increased body temperature, especially in hot weather. In the original add-on epilepsy controlled trials (using rapid titration such as 100-200 mg/day weekly increments), the proportion of patients who experienced one or more cognitive-related adverse events was 42% for 200 mg/day, 41% for 400 mg/day, 52% for 600 mg/day, 56% for 800 and 1000 mg/day, and 14% for placebo.

Topamax Precautions

Some of the cases were reported after exposure to elevated environmental temperatures. The majority of the reports have been in children. Adverse events most often associated with the use of Topamax were related to the central nervous system and were observed in both the epilepsy and migraine populations. Some patients who experienced one or more cognitive-related adverse events in the titration phase had a dose-related recurrence of these events in the maintenance phase. In the monotherapy epilepsy controlled trial, the proportion of patients who experienced one or more cognitive-related adverse events was 19% for Topamax 50 mg/day and 26% for 400 mg/day.