Quick Question on Topamax dosage

I am starting my Topamax tonight (god help me) and my doctor wants me to start at 25mg for first week than 50mg the next and finally 75 the next. My question to those that have taken it is:

Is 25mg a lot to start? I’m taking this in addition to 150mg of Effexor. I am prepared to be nauseous but would like to eliminate that as much as possible. Just wondering if you all think it is a high dose to start.

What have others started off at?



25mg is a standard dose to start at. That being said, it is still a difficult dose to get used to. It took me about 5 days to get used to 25 mg I didn’t go up to 50mg until day 7 of starting the medication and I won’t lie, I spent most of the first 4 days feeling rather poor.

Topamax worked wonderfully for me. After 1 month I saw significant improvement and after 3 months I am essentially 100%. But it was definitely difficult to get going on it. After 3 days I was ready to give up on it because it was making me feel awful, but I stuck it out and after about 6 days I was ok again. This unfortunately repeated every time I adjusted the dosage. It never caused any nausea for me, but it did cause significant dizziness and head pressure, as if I had triggered a massive migraine.

Some people start at 12.5mg because of this. I did not–I started at 25mg and went up by 25mg each time up to 100mg.

Hi Jamie

How many milligrams do you take now and did it cause you to lose weight?

I started at 25 mg as well. They had me cut the pills in half and take half in the morning and half in the evening for the first two weeks until I moved up to 50 mg. I moved up 25 mg every two weeks and it took two months before I felt normal again.

Jamie is right, is was a hard drug to get used to. My dizziness, brain fog, motion head intolerance always got worse for the first five days or so and then got better every time I up’d my dosage. The other symptom I noticed is depression. I got pretty depressed on the medication and I’m not normally a depressed person. I knew it was the medication so I stuck it out. It took me until reaching 100 mg and being on that dosage for about 2 or 3 weeks before I really started to feel a lot better. After that, it made the whole process worth it. It also never caused any nausea for me. It did cause fatigue at times. Unlike Jamie, I did not see any improvment until I was at 100mg.

I know you asked Jamie this question but I’ll answer to: I still at 100 mg. That dose works for me so I don’t expect they’ll change it. I have lost a little weight since I started topamax. I don’t drink carbonated beverages at all anymore (I really didn’t much before anyway). The drug makes them taste strange. I’m not has hungrey. I think it has suppressed my appetitie some. I have lost about eight pounds since I started in April.

Good luck.

You can always start lower, if you’re worried… I started at 12.5. Hardly had any SEs at all there. When I doubled to 25 was when I started to notice the SEs. Unfortunately, even after 5 weeks at 25, for me the SEs never went away and I had to give it up. You never know till you try, though! :wink:

I am at 100mg, 50 twice a day. It has not really affected my weight much at all, but most medications do not seem to have a large effect on my weight. My weight is a really constant thing in general so I wouldn’t read much into that. If anything I’ve actually gained a few pounds since starting it because I feel SO much better! I tend to eat less when I am unhappy (opposite of most people) so I am a bit odd in that respect.

Thanks everyone so much for all the responses. It all means so much. :smiley:

I ended up taking the 25mg last night and immediately got a bit light headed and dizzy (familiar territory) but it went away after awhile. I didn’t sleep great because i always take a Tylenol pm at night and I didn’t take it because I was too scared to take both. Do you guys think that would be too dangerous?

I feel a bit of pressure in my head and just light dizziness today, but happy to report that overall I am not feeling horrible. I know it’s early but I’m happy that the first day wasn’t a disaster. Some of these pills have made me sooooo sick and couldn’t even get out of bed. So I am very pleased with this update. I think most of my symptoms are from lack of sleep.

Praying for good results. Effexor has been a dream just need a little more.


Glad to hear things aren’t too bad. Hope topa gets you to 100%

Thanks Lisa, have you decided on next treatment plan? I am anxiou for you to start something as I’m really really pulling for you to find some relief soon.

You are in my thoughts daily.


Thanks for thinking of me. Topamax will be my next trial after I get off periactin. I am 1/2 way done with getting off periactin, and have been feeling even sicker during this process. my brain cannot handle ANY change. I’ve been completely bedridden and scared to death. I so desperately need topamax to work. don’t feel like I can take more of this torture. i feel so close to giving up, but I know I cannot, and have to continue trialing drugs. I’ve just have tried sooooooo many drugs that haven’t worked, it’s hard for me to believe that topamax might work.

Wow Lisa,

You are so brave! Wishing you well of course and think of you often.


Hi mavprincess

Quick question

Are you on effexor or the extended release version effexor xr?

— Begin quote from “nabeel”

Hi mavprincess

Quick question

Are you on effexor or the extended release version effexor xr?

— End quote

I am on the generic which is called venlaxifine and it is the extended release. Are you still on it? Have you seen any improvement. I really saw major improvement once I hit 150.

Unfort. I could not bare the side effects so had to get off. I am on cymbalta now which is helping with the anxiety but not the MAV. Added periactin and will see how that goes. If no improvement in 3 months then the next stop will be topamax