There appears to be a moderate drug interaction between Lexapro and Topamax.
Central nervous system- and/or respiratory-depressant effects may be additively or synergistically increased in patients taking multiple drugs that cause these effects, especially in elderly or debilitated patients.
During concomitant use of these drugs, patients should be monitored for potentially excessive or prolonged CNS and respiratory depression. Ambulatory patients should be counseled to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them, and to notify their physician if they experience excessive or prolonged CNS effects that interfere with their normal activities.
You can check for yourself using the drug interactions checker here...
Topamax is used as a daily preventative for migraines. As long as your prescriber is aware of all your meds, s/he will advise - or if you have any concerns raise them.
I currently use Topamax and Effexor XR. Granted Effexor XR is and SNRI and Lexapro is an SSRI - but there is an associated moderate risk between Topamax and Effexor XR as well. Based on my medical history that risk is monitored appropriately. That being said, for me the Topamax has only been about 50% effective at reducing my migraines. But 50% is pretty good. I still use a migraine abortive - either Axert or Imitrex but again you have to be very careful with your abortive meds because you CANNOT mix sumatriptans - very dangerous - potentially life threatening.
So you can likely use the Topamax but it's not going to relieve an active migraine.
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