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Topamax Withdrawal Symptoms

Topamax Withdrawal Symptoms

This entry was posted in Signs & Symptoms and tagged on by .

Last Updated on February 23, 2021 by Carol Gillette

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Alternative to Meds Editorial Team
Written by Diane Ridaeus Published Sep 19, 2018
Medically Reviewed by Dr Samuel Lee MD

Topamax withdrawal symptoms can present difficult and complex problems, such as a combining of resurfacing original unwanted conditions, i.e., rebound migraines or seizures, along with precipitating a new set of discontinuation reactions.

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.

Topamax and Liver Health

Topamirate is linked with hepatic ( liver ) failure. 2 In certain cases, coming off the drug would be imperative for overall health despite the discomforts that can accompany medication withdrawal. Because of the serious nature of underlying conditions the drug suppresses, such as seizures or migraines, these symptoms can rebound during or after withdrawal, especially where discontinuation is abrupt or sudden. Severe changes brought on by cessation can be avoided. 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 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 typically does cause significant weight loss. The drug makes food taste strange or even bad, and reduces food cravings. The drug manufacturers self-sponsored their clinical trials for weight loss use, which has raised conflict of interest concerns. Most of the participants did lose weight while on the drug, significantly more than the placebo group, however, the side effects discouraged many from continuing the trial.

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. Always seek medical oversight and attempt 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 BP disorder and is not generally supported by the medical community. 5

A person may decide to discontinue treatment with Topamax where it was ineffective to treat bipolar or similar conditions.

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 good health. Treating the biological and emotional triggers and precursors for addictive behaviors would be the best pathway forward.

Alternative to Meds Center Can Help

The 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.

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]



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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