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Does topiramate cause hair loss?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on March 13, 2023.

Official answer

  • Yes, topiramate (Topamax) has been shown to cause hair loss (alopecia) in studies, but it is not a common side effect.
  • Hair loss has been reported in 1% to 4% of children ages 6 to 16 years of age, and in 3% to 4% of patients older than 16 years of age.
  • Higher daily doses (400 mg/day) of topiramate were associated with greater rates of hair loss than lower doses (50 mg/day) in both age groups.

Hair loss with topiramate has also been reported in case reports in the scientific literature.

  • In one report, a 16-year old girl experienced hair loss after two months of using topiramate as an adjunctive treatment for epilepsy. The hair loss was reversed after treatment was stopped, but occurred again when topiramate treatment was restarted.
  • In another case, an 18-year old patient being treated with topiramate 50 mg/day for migraines developed hair loss after 3 months. The medicine was tapered and discontinued and hair loss stopped. Two weeks after reintroduction of the topiramate hair loss developed again. Once again after treatment discontinuation, the hair loss ceased.

Hair loss is a common side effect reported with other antiepileptic agents such as valproic acid and carbamazepine, and may cause cosmetic, social and compliance consequences for patients.

What has the FDA approved topiramate to treat?

Topiramate is used to help prevent seizures, either used alone or with other seizure medicines, in certain forms of epilepsy in patients 2 years of age and older. It is approved for migraine prevention in patients 12 years and older.

Common brand names for topiramate or extended-release topiramate include:

Generic topiramate is available as an oral tablet, capsule or extended-release capsule in various strengths and may be less expensive than brand names. If preferred, ask your doctor if a generic formulation is possible for your condition.

Which side effects can I expect with topiramate?

The most common side effects (≥10% and more frequent than placebo) reported in epilepsy studies in both adults and children include:

  • paresthesia (unusual feeling of the skin, such as burning, numbness, tingling, or “pin-and-needles”)
  • anorexia (loss of appetite)
  • weight loss
  • speech disorders
  • fatigue and somnolence (drowsiness)
  • dizziness
  • nervousness
  • mental slowing, slowed reflexes
  • vision changes
  • fever

In migraine studies in adults and children, side effects (incidence ≥5% and more frequent than placebo) were:

  • paresthesia
  • anorexia, weight loss, nausea
  • trouble with memory
  • altered taste
  • diarrhea
  • hypoesthesia (a decrease in sensations such as the feeling of touch or temperature)
  • stomach pain
  • respiratory tract infection

Related: View topiramate side effects, warnings and drug interactions (in more detail)

This is not all the information you need to know about topiramate for safe and effective use and does not take the place of talking to your doctor about your treatment. Review the full patient information for topiramate and discuss this information and any questions you have with your doctor or other health care provider.


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