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Topamax Withdrawal Symptoms

Last Updated on August 25, 2021 by Carol Gillette

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

Topamax withdrawal symptoms can present difficult and complex problems, such as rebound migraines or seizures, and newly emerging discontinuation reactions. Medical consensus generally advises a slow and gradual reduction to help avoid such adverse reactions.1,7,14-16

Topamax Withdrawal Symptoms:

  • Seizures*
  • Dehydration
  • Newly emerging or rebound migraines
  • Weight gain, increase in appetite
  • Shaking, tremors
  • Insomnia
  • Dizziness, vertigo feeling
  • Nausea
  • Mood swings, i.e., irritability, crying spells, anger or deep depression
  • Profuse sweating
  • Anxiety
  • Depersonalization
  • Confusion, cognitive impairment
  • Panic attacks
  • Muscle pain
  • Flu-like symptoms
  • Fatigue

*To avoid seizures the FDA recommended in its 2014 clinical review, gradual cessation rather than a patient stopping Topamax ( topiramate ) abruptly.1

Since Topamax withdrawal symptoms can include the return of seizures, medical caregivers should carefully monitor anyone for this common discontinuation symptom. Research has determined that after a seizure-free period of 2 to 5 years has elapsed, withdrawal from an antiepileptic medication is a medically sound context for many persons who may wish to safely stop their AED.14,15

Topamax and Liver Health

Topiramate is linked with hepatic ( liver ) failure.2 Kidney stone formation is another known outcome from taking Topamax.10 Where such risks to health are high, coming off the drug could be indicated despite the discomforts that can accompany medication withdrawal. Underlying conditions the drug suppresses, such as seizures or migraines can rebound during or after withdrawal, most notably where discontinuation is abrupt or sudden. Severe changes brought on by cessation can be avoided by a very gradual and well-monitored approach. Our general recommendations would minimally be two-fold:

  1. Never abruptly discontinue anti-seizure medication ( cold turkey ).
  2. Seek trained medical and clinical oversight during gradual tapering.

Topamax Side Effects:

According to safety reviews of topiramate used in children for migraines and epilepsy, and in adults for weight loss and other studies 1,11,12,17 the following adverse effects were found:

  • topamax side effectsSuicidality
  • Depression
  • Fatigue
  • Difficulty with concentration, focus, and memory
  • Mood problems
  • Paraesthesia (tingling sensation in the skin in various parts of the body)
  • Psychomotor disturbances
  • Impairment of taste sensation
  • Weight loss
  • Dizziness
  • Asthenia
  • Insomnia
  • Somnolence
  • Birth defects when used in pregnancy
  • Hyperthermia
  • Cognitive dysfunction, confusion
  • Acute myopia and other eye disorders
  • Infection
  • Flushing
  • Fever
  • Metabolic acidosis
  • Hypothermia when used concurrently with valproic acid

Topamax for Seizure Prevention

Topamax is a drug commonly used in the prevention of seizures.3 Seizures can be brought on because of various causes:

  • Epilepsy
  • Brain/head trauma
  • Heavy alcohol use, heavy amphetamine use
  • Withdrawal from alcohol and certain other drugs
  • Sleep deprivation
  • Brain tumor
  • Genetic factors
  • Infection
  • Venom (i.e., from insect bites)
  • Stroke

Topamax is one of several anticonvulsants that can successfully prevent or reduce the occurrence of seizures. However, the side effects can make the drug unsuitable for some.

Topamax for Weight Loss

Several other uses for Topamax have emerged over the last decade, including prescribing it as a weight-loss medication. Topamax is an appetite suppressant and studies confirm Topamax does cause significant weight loss. The drug makes food taste strange or even bad, and reduces food cravings. Most of the participants did lose weight while on the drug, significantly more than the placebo group, however, the side effects discouraged some from continuing the trial.18

Topamax for Migraine Headaches

Migraine sufferers have reported success by reducing the frequency and severity of chronic migraine headaches while taking Topamax.4 Unfortunately, the side effects that accompany the drug have caused some to decide to discontinue the medication. Alternative non-drug therapies have proven useful in reducing the frequency and intensity of migraines, such as mindfulness-based stress reduction and yoga therapies.8,9 Always seek medical oversight and guidance to reduce the dosage of anti-seizure or anticonvulsant medications gradually.

Topamax for Bipolar

Doctors have experimented with prescribing the drug for bipolar disorder. However, there is some controversy over this off-label use of the drug. According to clinical trials, Topamax has documented no success in treating mania in BP disorder and inconclusive benefits for depressive states in bipolar. Topamax research has not shown adequate efficacy in bipolar treatment.5,13

A person may decide to discontinue treatment with Topamax where it was ineffective to treat bipolar or similar conditions where the benefits were not achieved as was hoped.

Topamax for Cocaine Addiction

Clinical trials have been analyzed and found there is no clinical evidence that supports the use of Topamax for treating cocaine use disorder ( cocaine addiction ).6

A person may have been prescribed topiramate in an attempt to help with an addiction to something else, such as cocaine. This practice is not recommended because of the lack of efficacy, and the number of adverse effects linked to taking the drug. Withdrawal from Topamax could be a very good strategy for improved health, especially where it was not found useful in treating addiction to other substances. Treating the biological and emotional triggers and precursors for addictive behaviors would be alternative choices for the best pathway forward.

Alternative to Meds Center Can Help

find root causes for addictionThe protocols we use at Alternative to Meds Center aim toward several significant outcomes, aside from safe tapering from prescription drugs. One of the prime areas we investigate is finding root causes for the conditions that preceded the medication. If migraines linked to specific toxic accumulations, as an example, we can expect to see improvements after removing the toxicity. It is not always possible to reduce medications to zero. However many improvements become possible after changing diet, arming oneself with de-stressing therapies including counseling, and lifestyle changes. You are invited to review our services overview page to get a better idea of the massive volume of adjunct therapies available while inpatient at Alternative to Meds Center.

These and other techniques can help a person to make the necessary changes to conquer their health challenges, and many times without the undesirable consequences of over-medication. We invite you to call the number on this page for more information about the possible benefits we can provide you or a loved one who is suffering from Topamax withdrawal symptoms.


1. FDA Clinical ReviewTopamax ( topiramate ) 2/21/14 [cited 2020 Dec 17]

2. Bumb A, Diederich N, Beyenburg S. “Adding topiramate to valproate therapy may cause reversible hepatic failure.” Epileptic Disord. 2003 Sep;5(3):157-9. PMID: 14684351.[cited 2020 Dec 17]

3. Faught E. “Clinical studies of topiramate.” Drugs Today (Barc). 1999 Jan;35(1):49-57. doi: 10.1358/dot.1999.35.1.522948. PMID: 12973409. [cited 2020 Dec 17]

4. Silberstein SD, Neto W, Schmitt J, Jacobs D; MIGR-001 Study Group. “Topiramate in migraine prevention: results of a large controlled trial.” Arch Neurol. 2004 Apr;61(4):490-5. doi: 10.1001/archneur.61.4.490. PMID: 15096395. [cited 2020 Dec 17]

5. Ossner D, “Topiramate in Bipolar Disorder and Comorbidities: The Myths and the Evidence.” August 13, 2020 [cited 2020 Dec 17]

6. Singh M et al., “Topiramate for cocaine dependence – a systematic review and meta-analysis of randomized, controlled trials.” Society for the Study of Addiction 2016 Jan 30 [cited 2020 Dec 17]

7. Fariba K, Saadabadi A. Topiramate. [Updated 2021 Aug 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554530/ [cited 2021 Aug 25]

8. Niazi AK, Niazi SK. Mindfulness-based stress reduction: a non-pharmacological approach for chronic illnesses. N Am J Med Sci. 2011;3(1):20-23. doi:10.4297/najms.2011.320 [cited 2021 Aug 25]

9. Seminowicz DA, Burrowes SAB, Kearson A, Zhang J, Krimmel SR, Samawi L, Furman AJ, Keaser ML, Gould NF, Magyari T, White L, Goloubeva O, Goyal M, Peterlin BL, Haythornthwaite JA. Enhanced mindfulness-based stress reduction in episodic migraine: a randomized clinical trial with magnetic resonance imaging outcomes. Pain. 2020 Aug;161(8):1837-1846. doi: 10.1097/j.pain.0000000000001860. Epub 2020 Mar 13. PMID: 32701843; PMCID: PMC7487005. [cited 2021 Aug 25]

10. Vega D, Maalouf NM, Sakhaee K. Increased propensity for calcium phosphate kidney stones with topiramate use. Expert Opin Drug Saf. 2007 Sep;6(5):547-57. doi: 10.1517/14740338.6.5.547. PMID: 17877442. [cited 2021 Aug 25]

11. Sierra-Rodríguez MA, Rodríguez-Vicente L, Chavarri-García JJ, Del Río-Mayor JL. Acute narrow-angle glaucoma induced by topiramate with acute myopia and macular striae: A case report. Arch Soc Esp Oftalmol (Engl Ed). 2019 Mar;94(3):130-133. English, Spanish. doi: 10.1016/j.oftal.2018.11.005. Epub 2018 Dec 24. PMID: 30591244. [cited 2021 Aug 25]

12. Campbell E, Devenney E, Morrow J, Russell A, Smithson WH, Parsons L, Robertson I, Irwin B, Morrison PJ, Hunt S, Craig J. Recurrence risk of congenital malformations in infants exposed to antiepileptic drugs in utero. Epilepsia. 2013 Jan;54(1):165-71. doi: 10.1111/epi.12001. Epub 2012 Nov 21. PMID: 23167802. [cited 2021 Aug 25]

13. Arnone D. Review of the use of Topiramate for treatment of psychiatric disorders. Ann Gen Psychiatry. 2005 Feb 16;4(1):5. doi: 10.1186/1744-859X-4-5. PMID: 15845141; PMCID: PMC1088011.[cited 2021 Aug 25]

14. Epilepsy Foundation authors, “Stopping Medication” [online] 2020 [cited 2021 Aug 25]

15. Hixson JD. Stopping antiepileptic drugs: when and why?Curr Treat Options Neurol. 2010;12(5):434-442. doi:10.1007/s11940-010-0083-8 [cited 2021 Aug 25]

16. FDA label Topamax tablets, Topamax sprnkle capsules Approval 1996 [cited 2021 Aug 25]

17. Astrup A, Toubro S, “Topiramate: A New Pharmacological Treatment for Obesity” September 17, 2012 Obesity Research Journal [online] [cited 2021 Aug 25]

18. Kramer CK, Leitão CB, Pinto LC, Canani LH, Azevedo MJ, Gross JL. Efficacy and safety of topiramate on weight loss: a meta-analysis of randomized controlled trials. Obes Rev. 2011 May;12(5):e338-47. doi: 10.1111/j.1467-789X.2010.00846.x. Epub 2011 Mar 28. PMID: 21438989. [cited 2021 Aug 25]


Originally Published Sep 19, 2018 by Diane Ridaeus


This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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Topamax Withdrawal Symptoms
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