Alternative to Meds Editorial Team
Medically Reviewed by ATMC Clinical Review Team
Table of Contents:
Topamax withdrawal symptoms can present difficult and complex problems, such as rebound migraines or seizures, and newly emerging discontinuation reactions. Topamax (topiramate) is classed as an anti-epileptic drug but is also approved to treat migraine headaches. Many off-label uses have also developed and are described in more detail below.
No matter why Topamax was prescribed, medical consensus advises a slow and gradual reduction to help avoid severe adverse reactions.1,7,14-16
What we have found is that frequently there were original factors such as medical conditions, genetic factors, and toxic accumulations that contributed to the crisis. The person may have been diagnosed without a complete data profile, resulting in past misdiagnosis and failed treatment. Untangling these factors and providing a pathway to natural mental health is our area of expertise.
Topamax Withdrawal Symptoms
Topamax Withdrawal Symptoms can Include:
- 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 of 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 Topamax withdrawal can be avoided by a very gradual and well-monitored approach. Our general recommendations would minimally be two-fold:
- Never abruptly discontinue anti-seizure medication ( cold turkey ).
- 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:
Suicidality- 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 in 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 with their doctor’s guidance to consider Topamax withdrawal in tandem with safer alternatives to treat symptoms associated with bipolar or other conditions where Topamax did not help as 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 provide alternative choices for 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 Topamax withdrawal. One of the prime areas we investigate is finding root causes for the conditions that preceded the medication. If migraines are 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.
for Topamax Withdrawal Symptoms Help
Sources:
1. FDA Clinical ReviewTopamax ( topiramate ) 2/21/14 [cited 2022 Aug 29]
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 2022 Aug 29]
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 2022 Aug 29]
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 2022 Aug 29]
5. Ossner D, “Topiramate in Bipolar Disorder and Comorbidities: The Myths and the Evidence.” August 13, 2020 [cited 2022 Aug 29]
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 2022 Aug 29]
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 2022 Aug 29]
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 2022 Aug 29]
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 2022 Aug 29]
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 2022 Aug 29]
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 2022 Aug 29]
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 2022 Aug 29]
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 2022 Aug 29]
14. Epilepsy Foundation authors, “Stopping Medication” [online] 2020 [cited 2022 Aug 29]
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 2022 Aug 29]
16. FDA label Topamax tablets, Topamax sprnkle capsules Approval 1996 [cited 2022 Aug 29]
17. Astrup A, Toubro S, “Topiramate: A New Pharmacological Treatment for Obesity” September 17, 2012 Obesity Research Journal [cited 2022 Aug 29]
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 2022 Aug 29]
Originally Published Sep 19, 2018 by Diane Ridaeus
ATMC Clinical Review Team
The ATMC Clinical Review Team includes licensed physicians and experienced healthcare professionals dedicated to ensuring the accuracy, quality, and integrity of our medical content. The team reviews articles for clinical accuracy, evidence-based guidance, and relevance while supporting Alternative to Meds Center’s whole-person approach to mental health, recovery, and long-term wellness.
Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.