HomeAnswersNeurologyheadacheWhat are the risks of taking tablet Topiramate?

Is tablet Topiramate good for headaches?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Hitesh Kumar

Medically reviewed by

iCliniq medical review team

Published At November 13, 2021
Reviewed AtNovember 3, 2022

Patient's Query

Hello doctor,

I am a 57-year-old male in good health. I have suffered from severe headaches for several years, and recently they have got worse. Sumatriptan taken with Asprin, Acetominophen, and Cafein will help in reducing the pain, but they do not prevent them. I am attaching a headache log. I consulted my doctor, and he prescribed me Topiramate (Topamax). When I discussed about the tablet Topamax with a pharmacist, he discouraged me from starting the prescription due to its severe side effects like decreased cognitive function.

My query is, what are the risks of taking tablet Topiramate?

Thanks.

Answered by Dr. Hitesh Kumar

Hello,

Welcome to icliniq.com.

I would like to know some further details about your headache.

1) Since when you are having headaches?

2) In which part of the head do you feel pain?

3) What kind of headaches have you felt?

4) What is the duration of one episode of headache?

5) Do you have any nausea or vomiting during headache episodes?

6) Was your headache associated with any redness in the eyes, watering from eyes, or nasal blockage?

7) Have you noticed any specific triggering factors?

8) How frequent were those headaches?

9) What is the intensity of headaches?

10) Did you take any medicine for your previous headaches?

11) What was told by your doctor about the radiological impression of your lesion in the cervical spine?

12) How is your sleep pattern?

13) How is your usual mood in day-to-day activities?

14) How is your appetite?

Regarding Topiramate, it is used for migraine prevention. Some common side effects are dizziness, numbness, and paresthesia, which usually occur transiently at starting for a few days. It can also cause slight weight loss. But the bothersome side effect of Topiramate can be a rise in intraocular pressure and glaucoma, but that is rare.

Kindly revert with the answers.

Regarding follow up

Kindly revert with the information mentioned above to help you better.

Patient's Query

Hi doctor,

Thanks for the reply.

Here are the best answers I can give;

1) I have had headaches for at least 20 years.

2) The headaches are generally centralized to the frontal lobe.

3) Type of pain is the throbbing type with pressure behind my eyes. I also have stress-induced headaches.

4) Sometimes, it seems as though the headaches last for days.

5) I did not any medications.

6) There are no specific triggers for pressure headaches.

7) I currently have had headaches daily for almost a month.

8) The intensity is variable on the day between moderate to severe.

9) I am currently taking tablet Sumatriptan, Acetominophen, and Caffeine.

10) My vision will fluctuate. It has always been mild blurry vision.

11) I did not undergo any scans recently.

13) I will fall asleep relatively easily and sleep for eight hours daily.

14) My appetite is excellent.

Thank you.

Answered by Dr. Hitesh Kumar

Hello,

Welcome back to icliniq.com.

As per the description, your headaches seem to be migraine headaches, and in the course of so many years, they might have become chronic migraine headaches.

As the frequency of your headaches is quite high, with nine to ten episodes of headaches per month, you will need to be on some prophylaxis medicine for migraines. I would suggest taking tablet Propranolol (beta-blocker) 20 mg twice daily for regular prophylaxis, tablet Sumatriptan (serotonin receptor agonist) to be taken at the time of onset of similar kind of headache, and tablet Naproxen (non-steroidal anti-inflammatory drug) 500 mg to be taken if the intensity of the headache becomes severe. Topiramate (carboni anhydrase inhibitor) is also an option, but better prophylactic drugs are also there. As you have only one other medical problem (Gout), we can try other medicines quickly.

Also, as you have mentioned that you have mild congestion, I recommend you check for sinusitis. Sometimes sinusitis can also cause headaches over the forehead, and it may trigger migraine headaches.

Regards.

Investigations to be done

Kindly undergo a CT (computed tomography) scan of the brain, electroencephalogram, and ECG (electrocardiogram).

Differential diagnosis

Migraine headache.

Regarding follow up

Kindly review after one month.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Hitesh Kumar
Dr. Hitesh Kumar

Neurology

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