Maximum Topamax dosage


I’ve just been given Topamax to try today and they’ve told me to take 1 25mg tablet for 7 days, 1 x 25mg tablets twice a day for the next 21days and then 2 x 25mg tablets twice a day for the following 28 days.

Having read other posts where people have gone up in smaller amounts, does that seem fast to be moving up to 100mg within a month. And for those who have seen improvements on Topamax, what was your ideal amount?



Hi Jeni,
I was also told to increase to 100 mg within one month–7 days at 25 mg, then 7 days at 50 mg, then 7 days at 75 mg and finally 7 days at 100 mg. I’ve gone a bit slower and will finally be at 50 mg today at day 12.

I was told by my neuro that the maximum daily dose shown to be effective for migraine was 200 mg.

Let us know how it goes for you and best of luck!!

Thanks Anne

I’ve heard some horror stories about Topamax so I’m quite nervous about taking it. Particularly as the neurologist warned me about weight loss and I’m already very slim. However nothing ventured, nothing gained so I’m going to give it a go. I’ll let you know how it goes


Hi Jeni
I am petite and was slim also when I began taking topamax in December. I insisted on the 15mg. sprinkle caps (smallest dose manufactured) because my daughter had taken that dose as a teenager and it is easier to manage. My neuro (also my daughter’s doctor) was amused but fine with that. I’m so glad that I use the lower dose capsules due to my sensitivity to medication. I take a total of 75-90mg topamax daily, and it has been a lifesaver. I did lose 5-6 pounds without trying, but I also have to limit certain foods due to food intolerances and triggers. Raising the dose slowly usually works better with this medication.
Good luck and let us know how it goes.

Hi Gail,

are/were you a ‘24/7’ type mavver, as opposed to the ‘episodic’ type? And did you have to reach 75mg minimum before you saw any relief from the dizzies? Thanks,

Hi Tony - I was rather daily/chronic. My diagnosis was chronic daily migraine variant, primary symptom dizziness. I began getting results right away with my initial dose of topamax though it’s taken the full 75mg to really help after this many months. However, I have to also work with my diet, stress, and sleep to keep the dose down. Doses higher than 90mg make me sluggish, very cold, etc. At this dose I can still drink one small cup of coffee in the morning and go about my business but I still do not know if I will ever be “100%” again. However, I am very grateful for this level of functioning which is at about 85-90%.

Thanks for the replies. I’m on day 4 of 25mg Topamax and I’m having no problems with side effects yet. I’m pleasantly surprised as normally any medication that causes drowsiness will affect me. I go up to 50 mg on Monday. At times I think I can see subtle improvements already but I know this may just be a coincidence or wishful thinking (I’m an optimist!)

My main concern is definitely the weight loss. As I’m also very petite (5ft 1) and very slim, even losing a few pounds is bad news for me. Will be keeping a close eye on the scales. :smiley:

Gail - I’m pleased to hear you’ve had some success on topamax. If you don’t mind me asking, did you continue to lose weight or did it settle?

Will keep you all updated.


Jeni - I finally settled at a weight loss of around 6 pounds I think… I have problems with a number of carbs (grains, potatoes) and oil/grease so it’s been tough to keep the weight on without getting dizzy or feeling sick. Just a glitch in my system in addition to topamax spoiling my appetite in the beginning. After all these years I never thought I’d have a problem keeping weight on…it’s hard to fathom.