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How long do you stay on Topamax for migraines?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on June 20, 2023.

Official answer


Key Points

  • You can usually stay on Topamax (topiramate) to help prevent your migraine headaches as long as treatment is needed and remains safe for you.
  • You and your doctor will decide how long you stay on treatment. This will be based on how well it is working for you and any side effects you may experience.
  • You start treatment with lower doses and slowly increase over 4 weeks to help limit side effects.

Topamax is used for the preventive treatment of migraines in patients 12 years of age and older. It may not completely eliminate your migraine headaches.

Topamax is classified as an anticonvulsant (seizure) medication, but is prescribed for other conditions, too, such as migraine headache prevention.

Common side effects with Topamax when used for migraine prevention include:

  • paresthesia (unusual feeling of the skin, such as burning, numbness, tingling, or “pin-and-needles”)
  • anorexia (lack or loss of appetite)
  • weight loss
  • taste changes
  • diarrhea
  • difficulty with memory
  • hypoesthesia (a decrease in sensations such as the feeling of touch or temperature)
  • nausea

How long does it take Topamax to start working?

It may take 2 to 3 months for you to see the full effect of Topamax on your migraine headaches. In research studies, some patients had fewer headaches after one month of treatment.

Topamax for migraine prevention is usually started slowly at lower doses. Your doctor will slowly increase your dose over a 4 week period. The recommended daily dose of Topamax for migraine prevention is 50 mg twice a day (taken in the morning and evening).

Learn more: Topamax dosage (in more detail)

Topamax is available as oral tablets and as oral sprinkle capsules. Do not chew, break or crush the tablets as they have a bitter taste. The capsules can be swallowed whole or sprinkled on a small amount (a teaspoon) of soft food and consumed right away. Do not chew the food and medicine mixture.

Related Questions

How do I stop treatment with Topamax?

Do not stop taking Topamax without first talking to a healthcare provider. Stopping Topamax suddenly can cause serious problems. If you have epilepsy and you stop taking Topamax suddenly, you may have seizures that do not stop. You may also experience other serious withdrawal symptoms.

Your doctor will tell you how to stop taking Topamax slowly. This is usually done over a period of several weeks or longer.

Your doctor may also decide to change your dose. Do not change your dose without talking to your healthcare provider. Always take your Topamax exactly as prescribed by your doctor.

This is not all the information you need to know about Topamax (topiramate) for safe and effective use. Review the full Topamax information here, and discuss this and any questions you have with your doctor or other health care provider.


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