{"id":633400,"date":"2025-09-03T14:46:19","date_gmt":"2025-09-03T18:46:19","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=633400"},"modified":"2025-10-06T09:40:19","modified_gmt":"2025-10-06T13:40:19","slug":"topamax-long-term-side-effects","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/topamax-long-term-side-effects\/","title":{"rendered":"Long-term side effects of Topamax"},"content":{"rendered":"<p><a href=\"https:\/\/www.singlecare.com\/prescription\/topamax\"><span style=\"font-weight: 400;\">Topamax<\/span><\/a><span style=\"font-weight: 400;\"> (<\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/topiramate\"><span style=\"font-weight: 400;\">topiramate<\/span><\/a><span style=\"font-weight: 400;\">) is a brand-name prescription drug that\u2019s approved by the Food and Drug Administration (FDA) to treat certain types of epileptic seizures in people at least 2 years old and to prevent migraine in people at least 12 years old. It\u2019s also prescribed <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/off-label-prescription-drugs\/\"><span style=\"font-weight: 400;\">off-label<\/span><\/a><span style=\"font-weight: 400;\"> to promote weight loss and treat certain mental and behavioral health conditions. Topamax can cause side effects that patients should be aware of, and some side effects may be long-term. Here\u2019s what to expect and how to reduce the risk of negative side effects.\u00a0<\/span><\/p>\n<h2 id=\"what-are-the-most-common-side-effects-of-topamax\"><span style=\"font-weight: 400;\">What are the most common side effects of Topamax?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">In people with epilepsy, the most common <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/topamax-side-effects\/\"><span style=\"font-weight: 400;\">side effects of Topamax<\/span><\/a><span style=\"font-weight: 400;\"> include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Paresthesia (a tingling, prickling, or numb feeling in the skin)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Loss of appetite\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Weight loss<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Speech difficulty<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fatigue and drowsiness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Dizziness\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nervousness<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Psychomotor slowing (e.g., delayed reaction times, slowed thinking, slower gait)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vision problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fever<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">The following side effects are common in people who take Topamax to prevent <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/migraine-treatment-and-medications\"><span style=\"font-weight: 400;\">migraine<\/span><\/a><span style=\"font-weight: 400;\">:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Paresthesia<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Loss of appetite<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Weight loss<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Memory problems<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Changes in sense of taste<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diarrhea<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Decreased sense of touch<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nausea<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Abdominal pain<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Upper respiratory tract infection<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Many Topamax side effects are dose-dependent, meaning they\u2019re more likely to occur at higher doses.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In <\/span><a href=\"https:\/\/www.janssenlabels.com\/package-insert\/product-monograph\/prescribing-information\/TOPAMAX-pi.pdf\"><span style=\"font-weight: 400;\">clinical trials<\/span><\/a><span style=\"font-weight: 400;\">, 21% of participants aged 16 and older stopped taking the highest dose of Topamax due to intolerable side effects like memory problems, fatigue, weakness, insomnia, drowsiness, and a pins-and-needles feeling.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">People had less trouble with Topamax side effects at lower doses. At 200\u2013400 mg per day, only 11% of patients discontinued the drug.\u00a0<\/span><\/p>\n<h2 id=\"what-are-the-most-serious-side-effects-of-topamax\"><span style=\"font-weight: 400;\">What are the most serious side effects of Topamax?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Janssen Pharmaceuticals, the manufacturer of Topamax, warns about these severe side effects on the prescribing label:\u00a0<\/span><\/p>\n<ul>\n<li><b>Serious eye problems, <\/b><span style=\"font-weight: 400;\">which can cause blurred vision, decreased vision or loss of vision, and eye pain and redness.<\/span><\/li>\n<li><b>Decreased sweating <\/b><span style=\"font-weight: 400;\">can cause the body to overheat.<\/span><\/li>\n<li><b>Metabolic acidosis<\/b><span style=\"font-weight: 400;\">,<\/span> <span style=\"font-weight: 400;\">or a buildup of acid in the blood, can cause hyperventilation, irregular heartbeat, kidney stones, osteoporosis, and more.<\/span><\/li>\n<li><b>Suicidal thoughts and behaviors<\/b><\/li>\n<li><b>Cognitive problems <\/b><span style=\"font-weight: 400;\">can take many forms, such as memory, language, or speech problems, general confusion, poor concentration, and slow movements or reaction times.<\/span><\/li>\n<li><b>Psychiatric\/behavioral disturbances<\/b><span style=\"font-weight: 400;\">, like<\/span> <span style=\"font-weight: 400;\">depression or other mood disorders, tend to happen at higher <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/topamax\/dosage\"><span style=\"font-weight: 400;\">Topamax doses<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li><b>Fatigue and drowsiness <\/b><span style=\"font-weight: 400;\">are more common when Topamax is taken with at least one other <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/anticonvulsants\"><span style=\"font-weight: 400;\">antiepileptic drug<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/li>\n<li><b>Congenital disabilities <\/b><span style=\"font-weight: 400;\">caused by Topamax include small weight for gestational age, cleft palate, cleft lip, and other malformations.\u00a0<\/span><\/li>\n<li><b>Seizures <\/b><span style=\"font-weight: 400;\">can occur when people with epilepsy abruptly stop taking Topamax.<\/span><\/li>\n<li><b>Bone mineral density <\/b><span style=\"font-weight: 400;\">can decrease, which increases the risk of fractures.<\/span><\/li>\n<li><b>Slow growth <\/b><span style=\"font-weight: 400;\">has been reported in children who take Topamax.<\/span><b>\u00a0<\/b><\/li>\n<li><b>Stevens-Johnson syndrome and toxic epidermal necrolysis <\/b><span style=\"font-weight: 400;\">are widespread and potentially fatal skin infections that may occur while taking Topamax.<\/span><\/li>\n<li><b>Hyperammonemia, <\/b><span style=\"font-weight: 400;\">or a build-up of ammonia in the blood, can sometimes affect the brain.<\/span><\/li>\n<li><b>Kidney stones <\/b><span style=\"font-weight: 400;\">occur in people taking Topamax at a rate two to four times greater than in the general population.<\/span><\/li>\n<li><b>Hypothermia, <\/b><span style=\"font-weight: 400;\">a dangerous drop in body temperature, is more likely to occur when Topamax is taken with valproic acid.\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">\u201cMost Topamax side effects are not permanent and often improve over time or after discontinuation,\u201d says <\/span><a href=\"https:\/\/www.linkedin.com\/in\/sharon-batista\/\"><span style=\"font-weight: 400;\">Sharon Batista<\/span><\/a><span style=\"font-weight: 400;\">, MD, a board-certified psychiatrist who prescribes Topamax off-label for mood stabilization and eating disorders. \u201cWith appropriate medical supervision, serious or permanent complications are rare.\u201d\u00a0<\/span><\/p>\n<h2 id=\"are-there-any-topamax-side-effects-long-term\"><span style=\"font-weight: 400;\">Are there any Topamax side effects long-term?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Yes, some Topamax side effects are associated with long-term use, including kidney stones, bone loss, poor growth rates in children, and organ damage.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Your healthcare provider should routinely screen for long-term side effects of Topamax through eye exams, blood tests, urinalyses, and bone density tests.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Here\u2019s what they\u2019ll be looking for:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Eye problems or vision changes that may indicate glaucoma, which can lead to a permanent loss of vision if not treated<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Low bone mineral density, which can increase the risk of fractures at all ages and may affect children\u2019s growth rate<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Too much acid in the blood, a potentially fatal condition that can cause organ damage and muscle weakness, among other symptoms<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Too much ammonia in the blood, another potentially fatal condition that can damage organs and cause confusion<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Crystals, blood, or a pH imbalance in urine, which can help diagnose kidney stones<\/span><\/li>\n<\/ul>\n<p><a href=\"https:\/\/www.mindpath.com\/clinicians\/zishan-khan-md\/\"><span style=\"font-weight: 400;\">Zishan Khan<\/span><\/a><span style=\"font-weight: 400;\">, MD, a board-certified psychiatrist with Mindpath Health, says cognitive dysfunction is another possible long-term side effect of Topamax. \u201cOften described as word-finding difficulty, memory issues, or general mental fog, it can appear within weeks of starting treatment and may potentially persist for the duration of use. In some cases, especially after long-term exposure, these cognitive issues can linger even after discontinuation, though they are typically reversible over time.\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Weight loss can also occur with prolonged use of Topamax. Sometimes it\u2019s prescribed off-label for this purpose.\u00a0\u00a0<\/span><\/p>\n<h2 id=\"how-to-manage-topamax-side-effects\"><span style=\"font-weight: 400;\">How to manage Topamax side effects<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Managing Topamax side effects starts with a gradual titration schedule. Your provider should start you on a low dose\u2014usually 25 mg per day for adults\u2014and gradually increase the dose each week. \u201cThis significantly reduces the risk of cognitive side effects and paresthesia,&#8221; Dr. Khan says.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Other tips for managing Topamax side effects include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Drinking plenty of water to prevent <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/kidney-stone-treatment-and-medications\"><span style=\"font-weight: 400;\">kidney stones<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Eating smaller, more frequent, and nutritious meals throughout the day to combat nausea and weight loss<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Taking Topamax with food to soothe gastrointestinal discomfort<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Staggering the timing of other medications that affect the central nervous system or have a similar side effect profile<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Tell your healthcare provider about any adverse effects you notice while taking Topamax. \u201cRoutine check-ins and open communication with the prescribing physician are key to managing side effects before they become problematic,\u201d Dr. Khan says.\u00a0<\/span><\/p>\n<h3 id=\"when-to-stop-taking-topamax\"><span style=\"font-weight: 400;\">When to stop taking Topamax<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Talk to a healthcare professional immediately if you notice eye pain or blurred vision. This can be a sign of a serious eye problem, which can cause irreversible vision loss if not treated right away. Discontinuing Topamax right away can prevent further eye damage.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">You should also seek medical attention right away if you have skin pain or a rash, blistering or peeling skin, burning eyes, or fever. It could be Stevens-Johnson syndrome or toxic epidermal necrolysis. Quickly (but safely) stopping Topamax is critical for fighting this potentially fatal infection.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Due to the risk of harm to an unborn baby, your healthcare provider may also recommend stopping Topamax treatment if you become pregnant.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">However, aside from these urgent cases, it\u2019s not safe to suddenly stop taking Topamax without gradually lowering the dose. For example, if you have a bothersome side effect that is not serious, your healthcare provider may advise you to gradually decrease the dose. \u201cAbrupt Topamax discontinuation can trigger withdrawal symptoms like irritability, dizziness, and worsening of the underlying condition,\u201d Dr. Batista says. \u201cThe dose should always be tapered under medical supervision.\u201d<\/span><\/p>\n<h2 id=\"topamax-alternatives\"><span style=\"font-weight: 400;\">Topamax alternatives<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">In clinical trials, 21% of adult participants stopped taking Topamax due to intolerable side effects. The risks of any medication shouldn\u2019t outweigh the benefits, so if your quality of life is affected by tingling in your arms and legs, fatigue, nausea, attention problems, insomnia, or other side effects, it\u2019s worth talking to your healthcare provider about <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/topiramate-alternatives\/\"><span style=\"font-weight: 400;\">Topamax alternatives<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<h3 id=\"alternative-epilepsy-treatments\"><span style=\"font-weight: 400;\">Alternative epilepsy treatments<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">When it comes to controlling epileptic seizures, your healthcare provider has more than a dozen Topamax alternatives to choose from. However, Dr. Khan suggests asking about two in particular:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/prescription\/keppra\"><span style=\"font-weight: 400;\">Keppra<\/span><\/a><a href=\"https:\/\/www.singlecare.com\/prescription\/levetiracetam\/dosage\"><span style=\"font-weight: 400;\"> (levetiracetam)<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/prescription\/lamictal\"><span style=\"font-weight: 400;\">Lamictal<\/span><\/a><span style=\"font-weight: 400;\"> (lamotrigine)\u00a0<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Based on <\/span><a href=\"https:\/\/www.ucb.com\/sites\/default\/files\/2024-03\/master_keppra_ir_os_12Mar2024_en.pdf\"><span style=\"font-weight: 400;\">clinical trial data<\/span><\/a><span style=\"font-weight: 400;\">, levetiracetam appears to be more tolerable than Topamax and associated with fewer long-term side effects. Dr. Khan says <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/levetiracetam\"><span style=\"font-weight: 400;\">levetiracetam<\/span><\/a><span style=\"font-weight: 400;\"> is an effective anticonvulsant but can sometimes cause irritability or mood changes.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/www.singlecare.com\/prescription\/lamotrigine\"><span style=\"font-weight: 400;\">Lamotrigine<\/span><\/a><span style=\"font-weight: 400;\"> shares some side effects with Topamax, such as a <\/span><a href=\"https:\/\/gskpro.com\/content\/dam\/global\/hcpportal\/en_US\/Prescribing_Information\/Lamictal\/pdf\/LAMICTAL-PI-MG.PDF\"><span style=\"font-weight: 400;\">risk of vision problems<\/span><\/a><span style=\"font-weight: 400;\"> and life-threatening rashes. But lamotrigine also offers similar benefits to Topamax because it doubles as a mood stabilizer.<\/span><\/p>\n<h3 id=\"alternative-migraine-treatments\"><span style=\"font-weight: 400;\">Alternative migraine treatments<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">If you\u2019re looking for a medicine to prevent <\/span><a href=\"https:\/\/www.singlecare.com\/conditions\/migraine-treatment-and-medications\"><span style=\"font-weight: 400;\">migraine<\/span><\/a><span style=\"font-weight: 400;\">, Dr. Khan says the following are popular options with different side effect profiles than Topamax:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/prescription\/propranolol-hcl\"><span style=\"font-weight: 400;\">Propranolol<\/span><\/a><span style=\"font-weight: 400;\">\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/prescription\/amitriptyline-hcl\"><span style=\"font-weight: 400;\">Amitriptyline<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><a href=\"https:\/\/www.singlecare.com\/prescription\/aimovig\"><span style=\"font-weight: 400;\">Aimovig<\/span><\/a><span style=\"font-weight: 400;\"> (erenumab-aooe)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Propranolol is a <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/beta-blockers\"><span style=\"font-weight: 400;\">beta blocker<\/span><\/a><span style=\"font-weight: 400;\"> that\u2019s FDA approved to reduce high blood pressure, but it\u2019s also prescribed off-label to prevent migraine headaches. \u201cIt has fewer cognitive side effects than Topamax, but can cause fatigue or exacerbate asthma,\u201d Dr. Khan says.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Amitriptyline is a <\/span><a href=\"https:\/\/www.singlecare.com\/drug-classes\/tricyclic-antidepressants\"><span style=\"font-weight: 400;\">tricyclic antidepressant<\/span><\/a><span style=\"font-weight: 400;\"> that\u2019s prescribed off-label for chronic pain management and migraine prevention. \u201cIt\u2019s effective but may lead to sedation and weight gain,\u201d Dr. Khan says. Like Topamax, amitriptyline may cause suicidal thoughts or behaviors.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Finally, Aimovig is a brand-name injectable medication that\u2019s FDA approved to prevent migraine headaches. It belongs to a class of drugs called CGRP inhibitors, which Dr. Khan describes as newer migraine treatments with fewer side effects. The <\/span><a href=\"https:\/\/www.pi.amgen.com\/-\/media\/Project\/Amgen\/Repository\/pi-amgen-com\/Aimovig\/aimovig_pi_hcp_english.pdf\"><span style=\"font-weight: 400;\">prescribing information for Aimovig<\/span><\/a><span style=\"font-weight: 400;\"> lists just two common side effects: injection site reaction and constipation. On the downside, CGRP inhibitors tend to be pricey because there are no generic versions available yet.\u00a0<\/span><\/p>\n<h3 id=\"other-alternatives\"><span style=\"font-weight: 400;\">Other alternatives<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">There is a wide variety of mood stabilizers and <\/span><a href=\"https:\/\/www.singlecare.com\/resources\/weight-loss\"><span style=\"font-weight: 400;\">weight loss drugs<\/span><\/a><span style=\"font-weight: 400;\"> that can be prescribed instead of Topamax. Talk to your healthcare provider if you\u2019re considering switching from Topamax to another medication.\u00a0<\/span><\/p>\n<h2 id=\"bottom-line\"><span style=\"font-weight: 400;\">Bottom line<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Taking Topamax long-term could increase your risk of problems such as kidney stones, organ damage from too much acid or ammonia in your blood, fractures or osteoporosis from decreased bone density, cognitive dysfunction, and weight loss. In children, prolonged Topamax use can slow growth.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Your healthcare provider will run periodic tests to make sure you remain healthy while taking Topamax and can help you find an alternative if needed. Don\u2019t stop taking Topamax without talking to your healthcare provider due to the risk of withdrawal symptoms. <\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Topamax (topiramate) is a brand-name prescription drug that\u2019s approved by the Food and Drug Administration (FDA) to treat certain types of epileptic seizures in people at least 2 years old and to prevent migraine in people at least 12 years old. It\u2019s also prescribed off-label to promote weight loss and treat certain mental and behavioral [&hellip;]<\/p>\n","protected":false},"author":149,"featured_media":633401,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4589],"tags":[12752],"coauthors":[21074],"class_list":["post-633400","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-info","tag-medication-side-effects","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Long-term side effects of Topamax<\/title>\n<meta name=\"description\" content=\"Topamax (topiramate) is prescribed for epilepsy, migraine prevention, and off-label uses, but it may cause long-term side effects that need to be monitored.\" \/>\n<meta name=\"robots\" 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