Eye problems can lead to permanent loss of vision if not treated. Tell your doctor beforehand if you've had glaucoma and report eye pain, redness, or vision changes during treatment.
Decreased sweating makes it more difficult for your body to cool down when it gets very hot and might make you more vulnerable to heat-stroke. Avoid exposure to heat, drink plenty of fluids, and notify your doctor if you have a fever.
Suicidal thoughts or actions should be reported immediately to your doctor, including panic attacks, agitation, irritability, anxiety, depression, sleep problems, talking or thinking about suicide, and any other changes in behavior or mood.
Excess acid in the blood (acidosis) can cause tiredness, loss of appetite, irregular heartbeat, and impaired consciousness, and is more likely if you consume a high-fat, low-carbohydrate diet or have kidney disease, respiratory problems, or diarrhea. Tell your doctor if you have any of those conditions before or during treatment, and don't follow a high-fat, low-carb diet while taking the medication.
Kidney stones might develop. Drink six to eight glasses of water a day and tell your doctor beforehand if you've ever had kidney stones.
Cognitive problems involving thinking, concentration, attention, memory or speech might occur. Topiramate has also been found to cause confusion, dizziness, and sleepiness. Don't drive a car or operate machinery until you know how the drug affects you, and avoid alcohol and sedating drugs.
Other side effects include headaches, tingling in the hands or feet, dry mouth, nausea, taste disturbance, diarrhea, upset stomach, and menstrual problems. Additionally, the FDA recently announced that Topamax can cause birth defects in humans.
Drug interactions include reduced effectiveness of birth-control pills. Tell your doctor what prescription and over-the-counter medications and supplements you are taking or plan to take.
Sudden withdrawal from topiramate can cause serious problems. Don't stop taking it without first talking to a doctor.
Tell your doctor before treatment if you've ever had liver problems, osteoporosis, or mood disorders, or if you're pregnant, planning to become pregnant or breast-feeding.