Topamax: Five and a Half Months Later

I’m sure all y’all have been eagerly awaiting an update on what’s been happening with Topamax, the antiepileptic medication that caused me to function at the level of a second-grader drugged on sleeping pills when I started taking it in May.

Well, you’ll be pleased to know that tremendous progress has been made: I now operate at average middle-schooler levels and manage to stay awake for much longer tracts of time, though it takes significant effort to push through the 11 a.m.—3 p.m. period without a lengthy nap.

Besides fatigue, another Topamax issue is that I need to consume more than I used to in order to maintain my weight, which would be awesome if I weren’t nauseated much of the time. I handle the fact that it’s used off-label as a weight-loss drug—yes, really—by having frequent mini-meals, supplementing them with snacks. Though I still derive some pleasure from food, eating’s become a chore. Oh, Topamax.

Then there’s the prevailing Topamax-exacerbated mood stuff. I won’t get into that.

The cognitive side effects of Topamax are, however, what scare me most, especially as I look ahead to January, when I’m supposed to go back to school. I’ve seen a ton of improvement, but I’m definitely “slower” now, and word recall continues to be a major problem. (What’s the name for that orange item that people eat at breakfast? Oh right, an orange. How will I finish a thesis if I periodically find myself staring blankly at a citrus fruit?)

Positive thinking, KG, positive thinking.

I have an appointment with my epileptologist in mid-November at which I’m going to bring up the idea of trying another AED. The thing is, this is the first med that’s made a huge difference in terms of seizure control, even if it hasn’t worked miracles. As always, it’s a balancing act: seizures aren’t fantastic so far as cognitive function is concerned (slight understatement), and Topamax is bad in terms of general quality of life; it’s a catch-22 that I’m ill-equipped to resolve. (Is it a catch-22? Topamax makes me question the weirdest things.)

What it comes down to is that having epilepsy of the variety I do means accepting that I need to make sacrifices, at least in the short-term. Continuing to take Topamax until I can find something better is one of those.