Topamax Side Effects

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Topamax was approved by the FDA in 1996 to treat epilepsy. Eight years later, Topamax received additional FDA approval to prevent migraine headaches. Millions of patients have received relief of their symptoms by using Topamax. However, the active ingredient topiramate is associated with a number of severe health complications. Topamax side effects can include glaucoma, suicidal tendencies, and birth defects when taken during pregnancy.

Common Topamax Side Effects

When Topamax was first marketed, the label originally warned users only of the more common Topamax side effects. These Topamax side effects were described as “mild to moderate.” The more common Topamax side effects typically include symptoms such as fatigue and nausea. Topamax patients may also develop a condition called pareshesia. Paresthesia is characterized by a sensation of tingling, tickling, pricking, burning, or numbness. These sensations are known to primarily occur in the legs and arms.

Other Topamax side effects include:

  • Diarrhea
  • Unusual weight loss
  • Taste change
  • Nervousness
  • Appetite loss
  • Infection of the upper respiratory tract

Severe Topamax Side Effects

The most severe Topamax side effects can cause death if the patient fails to receive proper and timely treatment. Patients may also suffer Topamax side effects that influence cognitive or neuropsychiatric function. Patients have reported symptoms such as confusion, slowing of psychomotor function, concentration and memory difficulty, and problems with language or speech. Oligohydrosis, or decreased sweating, may occur. This can lead to hyperthermia, or a dangerous increase in body temperature.

Eye Problems

Topamax side effects include serious eye conditions that may lead to blindness. Acute myopia is a reported Topamax side effect. This condition can cause headaches and blurred vision due to increased pressure within the eye. Secondary angle closure glaucoma is another condition that results as a Topamax side effect. Patients should seek medical attention immediately if they experience pain or discomfort in the eyes.


A number of reports have indicated suicide as a Topamax side effect. Patients may experience suicidal thoughts and tendencies during use. It is recommended that all patients are carefully monitored during treatment. Medical attention should be sought if the patient experiences symptoms such as anxiety, panic, onset or increased depression, or other significant changes in behavior or mood.

Metabolic Acidosis

Metabolic acidosis is a Topamax side effect that results in an excessive amount of bodily acid in the bloodstream. This is caused by acid production that occurs so rapidly that the kidneys cannot filter quickly enough. Severe metabolic acidosis can cause shock or death. Symptoms include rapid breathing, low blood pressure, lethargy, and confusion.

Topamax Birth Defects

Topamax side effects include severe birth defects if taken during pregnancy. The FDA listed Topamax in pregnancy category D. Drugs in pregnancy category D show sufficient evidence of causing harm to human fetuses. It is highly encouraged for pregnant women to avoid taking Topamax in order to avoid pregnancy-related Topamax side effects.

Oral Cleft Deformities

A 2008 study showed that babies born during Topamax treatment were 16-times more likely to suffer birth defects. The primary Topamax birth defect is oral cleft, such as cleft lip and cleft palate. These Topamax side effects are orofacial disorders that cause the skull’s plates to improperly fuse together. This results in an opening at the roof of the newborn’s mouth. In many cases, these malformations require multiple surgeries to correct.

Persistent pulmonary hypertension of the newborn

Another Topamax side effect is persistent pulmonary hypertension of the newborn (PPHN). PPHN constricts the arteries that lead to a newborn’s lungs. This restricts the amount of blood flow to the lungs. In turn, the amount of oxygen entering the bloodstream is also restricted. Intubation and ventilation is often required to treat PPHN. It is estimated that up to 20 percent of infants with this condition do not survive.

Other pregnancy-related Topamax side effects include:

  • Malformation of the limbs
  • Lung and heart defects
  • Neural tube defects, such as spina bifida

View Sources

  1. Bhattacharyya, Kalyan. “Acute myopia induced by topiramate: Report of a case and review of the literature.” Neurology India. 53.1 (2005): 108-109. Web. 3 Apr. 2013.;year=2005;volume=53;issue=1;spage=108;epage=109;aulast=Bhattacharyya
  2. “FDA Drug Safety Communication: Risk of oral clefts in children born to mothers taking Topamax (topiramate).” U.S. Food and Drug Administration. U.S. Department of Health and Human Services, 3 Mar 2011. Web. 3 Apr 2013.
  3. Steinhorn, Robin. “Neonatal Pulmonary Hypertension.”Pediatr Crit Care Med.. 11.2 (2010): S79-S84. Web. 3 Apr. 2013.
  4. “Topiramate TOPAMAX (generic) (brand).” The Brown University Psychopharmacology Update Sept. 2012: 9+. Academic OneFile. Web. 4 Apr. 2013.
  5. Vijaya, Lingham. “Topiramate induced secondary angle closure glaucoma.” Journal of Postgraduate Medicine. 52.1 (2006): 72-73. Web. 3 Apr. 2013.;year=2006;volume=52;issue=1;spage=72;epage=73;aulast=Sachi
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