Topamax for Neuropathic Pain

Topamax, or topiramate, is traditionally used as an anti-seizure medication. This medication is also becoming commonly prescribed for nerve pain and this is why my doctor prescribed it. Other popular anti-seizure medications, including Lyrica and Neurontin, caused me to experience life-threatening side effects so it was a gamble trying Topamax. We were two for two on emergency ER visits. I was willing, however, because the nerve pain is just becoming increasingly too much to bear.

Topamax Dosing for Nerve Pain

Due to my history of severe reactions, we started off with 25 milligrams, once a day for a week. I admit, that first dose was terrifying, but I took it and went to sleep. When I did not wake up with a sore throat, I knew this medication was going to be different. My life-threatening reaction with Neurontin began with a sore throat the morning following the first dose, a cough the second day along with a rapidly spreading rash, then a fever and then a medical emergency. So, with the Topamax, we upped the dose to 25 milligrams, twice a day after that first week. I stayed on that dose for about six weeks.

I just say my doctor on Thursday. We decided I would now take 50 milligrams at night and continue taking 25 milligrams in the morning. In two weeks, as long as the increase is tolerable, I will increase again to 50 milligrams in the morning and 50 milligrams at night. I will see my doctor again during the last week of June to reevaluate my dosage and increase it if the pain still requires it.

With all patients taking this drug for nerve pain, the dose is increased gradually just like my doctor is doing. Your doctor will not hit you with too high a dose too fast.

Topamax Side Effects

Looking at the list of side effects is incredibly intimidating. There are at least 50 or more possible side effects with this drug. I fully expected a few and currently am experiencing a few. The first side effect I experienced is known as paresthesia. It is where my feet and hands burn and tingle. When I first started taking the drug, this side effect was more severe and occurred more frequently. It may worsen and occur more often again now that I am increasing the dose again. The side effect is not constant, however, and usually only lasts a few minutes here and there.

Nothing I eat tastes the same. Many patients report a metallic taste, but that is not what I am experiencing. For me, nothing tastes like metal, it just does not taste like it should. I also have no appetite. I usually eat a quarter sandwich at a time before I am completely full. I drink protein shakes and nutritional shakes to get my vitamins, minerals and some calories in each day. I've definitely lost weight and continue to. However, a previous course of high-dose corticosteroids caused weight gain, so I had a few extra pounds to lose.

I am also tired and just generally fatigued. More than usual. I don't really need to sleep, but definitely feel sluggish. Now that I am used to my current dose I am fine, but now that I am increasing, I know the sluggishness and fatigue will return until my body adjusts again. I also struggle with more memory and other cognitive problems than normal. I forget little things like what I got up to get or what channel I was trying to change the TV to. I have also noticed heartburn more often, but only if I forget to take my Nexium so it could be related to forgetting to take that medication.

I also have random aches in the bones, not joints, but bones, in my toes and fingers. It is not a terrible ache and it does not last long, but it can be mildly annoying.

Compared to the extensive list of possible side effects, I feel quite lucky that this is all I experience.

Resources

PubMed Health: Topiramate