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Q. Is tablet Topiramate good for headaches?

Answered by
Dr. Hitesh Kumar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 13, 2021 and last reviewed on: Nov 17, 2021

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.

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#

Hello,

Welcome to icliniq.com.

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

1) Since when you are having headaches?

2) which part of the headaches?

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:

Revert with the informations mentioned above to help you better.

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) Not under medications.

6) 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. I have always been mildly blurry.

11) I have not had any scans recently.

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

14) My appetite is excellent.

Thanks.

#

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 20 mg twice daily for regular prophylaxis, tablet Sumatriptan to be taken at the time of onset of similar kind of headache, and tablet Naproxen 500 mg to be taken if the intensity of the headache becomes severe. Topiramate 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:

CT (computed tomography) of brain, electroencephalogram, and ECG (electrocardiogram).

Differential diagnosis:

Migraine headache.

Regarding follow up:

review after one month.


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