Why Hello There, Old Frenemy: Topamax Returns

Just when I thought I’d broken up with Topamax, it’s weaseled its way back into my life.

For good reason, I guess: seems that it was making more of a difference than I thought it was. Turns out that when your baseline is “seizures all the time,” it’s possible for a drug to lower this standard to “seizures just three or so days a week,” which makes it quite effective, actually. A good way to discover this is by lowering the dose.

Seizures galore! Seizures for everyone! (Well, just for me, actually—sorry, I’m not good at sharing.)

In short, bringing my dose from 300 mg/day to 200 mg/day as part of the process of transitioning to Pregabalin was enough to cause a major spike in tonic clonic seizures. (I’d been mostly having complex partial ones previously.) Last week, I contacted my epileptologist, who said to stop reducing the Topamax until I’m at a full dose of Pregabalin; my husband phoned him on Monday after a seizure-filled weekend, and he said to increase back to 300 mg. In other words, Topamax and I are exactly where we started.

I am choosing to love you, Topamax. Or at least tolerate you.


When I think about this rationally, I’m grateful for Topamax’s existence: these past few weeks on a reduced dose have been unpleasant, to put it mildly. Maybe we needed this little partial break in order for me to properly appreciate Topamax’s merits rather than constantly dwell on its (many) faults. So what if it gives me pesky cognitive issues? Who cares if it makes me super sleepy? Having now seen the alternative, I welcome you, frenemy, with open arms.


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