... I have Major Depressive Disorder, Generalized Anxiety, and Dysthymia. I currently take Paxil CR (62.5mg once a day) and was just prescribed Topamax (25mg 1-2 times per day) as an adjunct for the Paxil. So far it makes my hands and feet cold, takes me tired and groggy, sometimes still a bit sad. But I am sleeping better with a more regular schedule. Before the Topamax I was trying to deal with some breakthrough depression from the loss of a friend, a beloved pet, insomnia, a serious turn in my physical health and my continuing struggle with unemployment. I was getting pretty frustrated and had made a number of suicide attempts and the doctor prescribed the Topamax. So far I feel better. But it has only been 3.5 weeks. I am tired of feeling cold and sleeping. Your comments would be appreciated. Thanks