Treatment with Topiramate, also known as Topimax

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Topiramate is used as a preventive medicine for migraines

The preparation

Topiramate has been developed to treat epilepsy, but scientific studies have shown that it can also have an effect on migraines.

Impact

Topiramate stabilizes the electrical activity of the brain. This is probably why it has a preventive effect in migraines. Topiramate does not remove the migraine. A realistic treatment goal is a halving of seizures. In some more, in others less.

Side effects

The most common side effects are tingling and tingling in the hands, nausea and a slight weight loss. In addition, fatigue, dizziness, decreased ability to concentrate, difficulty finding words, and depression may occur. In rare cases, kidney stones may occur. At high doses, the effect of birth control pills may decrease.

Precautionary measures

It is important not to become pregnant during treatment with topiramate, which is why barrier contraception (e.g. condoms) is recommended.

Before the start of treatment

Before starting treatment, blood tests in the form of fluid counts should be available.

What dose to take


Uge Morgen Aften Døgndosis
1-2
- 25 mg 25 mg
3-4 25 mg 25 mg 50 mg
5-6 25 mg 50 mg 75 mg
7-frem 50 mg 50 mg 100 mg

Usually start by taking 25 mg once a day for 14 days. Then increase by 25 mg every 14 days in 2 doses until reaching 50 mg in the morning and 50 mg in the evening (i.e. daily dose of 100 mg). It is the usual maintenance dose. Some have good efficacy at daily doses of 50-75 mg.

In the absence of effect and if there are no bothersome side effects, after one month it can be increased to 100 mg in the morning plus 50 mg in the evening for 2 weeks and then to 100 mg twice a day (that is, the daily dose of 200 mg).

If there is no effect from this dose after about 2 months, it can be concluded that topiramate does not work on you. You should then step down by 50 mg per week until you are completely off the medication

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