Topamax and Headaches

Many of my patients come to me with questions about Topamax and headaches, which is one of the newer anti-seizure medications. (By new, I mean it is less than 20 years old..in medicine that's new!)They have heard about it from their friends or read about it elsewhere. So what's up with Topamax and headaches?

Well, they are right! It does help with certain recurring headaches. Topamax affects headaches by reducing the number and severity of the headaches. It can also slow the "take off phase" of a headache, allowing you to get some medication in you faster to stop the process.

Topamax is a preventative medication. You will be on low doses every day. Most people are on it for a few months, perhaps a year until control is reached.

See? I said control, not cure! Control means you get one or two mild headaches every month or so. One dose of a medication takes the headache away. Topamax is most effective for migraines, but I have used it and seen it be effective with some cluster patients and some post-traumatic headaches.

SIDE EFFECTS: Now just about every drug has side effects but the art of medicine is balancing those against the benefit of treating the pain.

Topamax can cause weight loss in a significant number of people who take it. Woo-hoo! I can hear you cheering! But this can reverse itself after you stop the medication and it is not a reason by itself to prescribe it.

It also causes numbness and tingling in the hands and feet but that wears off after a few months and is usually mild.

You should probably NOT take Topamax if you have had any of the following problems: kidney stones, renal disorders, glaucoma, anorexia.

All medication should be prescribed by a licensed health care professional.

Topamax and Children's Headaches

Drs Ferraro and Tripani in Italy, reviewed five different studies in children and found "Topiramate has been proven to reduce headache frequency and the accompanying disability." This is good news and I can tell you we use Topamax for our teenagers in our headache clinic.

Side effects? Pretty much the same as what happens in the adult population, weight loss (NOT a drug for thin children or history of anorexia/bulemia), tingling in the fingers and toes, difficulty concentrating and abdominal pain.

These effects do not happen with every child, and if a problem the drug is easily withdrawn.

For more information on child migraine and abdominal migraine read here.

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