Hi all, asked my GP for a lower dose of topiramate, decided to take all advice and start low and slow. I was given 15 mg capsules to take at bedtime. My question is do you work up to taking the 50 mg at night THEN add the morning dose or do you start at a dose at night, add in the morning dose and then increase night then morning as you go along??
Any advice would be appreciated.
Angela
Here in the U.S., my daughter took the 15 mg capsules and she increased by 15 mg every 2 weeks. Here is how her doctor had her take the pills: one at night, then 2 at night, then the 2 at night and 1 in the morning, then 3 at night and 1 in the morning, then the 3 at night and 2 in the morning…and that’s as far as she got because she had side effects. We reversed this pattern to wean her off them, but the doctor had her reduce by 1 pill each week. Hope that helps and good luck! I wouldn’t think there’d be any harm in taking it slower than 2 weeks per step if you wanted to be cautious, would there?
Ange
I worked up to taking 50mg at night over 2 months. Then gradually added 25mg in the morning up to 3mths. Now I have the option of slowly increasing the morning dose up to 50mg. (I have the 25mg tabs & cut them in half to achieve the slow increase).
I know the normal practice is to balance the dosage morning & night. I’ve been a bit concerned in case it makes me too ‘slow’ during the day when I increase the med. I’ve discussed this with my GP this week. She said that I can take a larger dose at night if I wish & see how it goes. Have any other Topamax users tried alternative ways of taking the 100mg dose?
Barb
Hi,
Topamax has been a friend for me! starting dose 25mg before bed, I stayed on this for about 4 weeks - pretty much until most side effects had gone, then increased to 25mg in the morning, - waiting until my body was accustomed to Topamax - it was like I was waiting for my body to say OK OK, I’m used to this dose now… bring it on!! so again after another 3 or so weeks I would increase by another 25mg in the evening bringing my dose to 75mg, wait again 3 or so weeks depending on side effect etc… then add another 25mg to my morning dose. (50mg Morning - 50mg Evening). Working well for me, taking every day as it comes! 
barb how is the topamax going for u? has it helped your balance or visual vertigo?
my neuro says there is no set rule for migraine.he says the equally divided doses is necessary for patients with epilepsy. for migraine he goes up to 100mg a night with no morning dose and sometimes even more than 100mg. i am on 75mg at night for about 3 weeks now. plan to go up to 100mg by mid may if i dont see any further improvemenets
that’s interesting that several people on here seem to take all of it at night. My dr. said that with the anticonvulsants, they can work if you take them all at night, but they will ususally work better (or at all) if you take them during the day too.I wonder if some people on here could get away with a lower dose if you split it up between morning and night?
Hi all,
I started with 12.5mg at night (cut a tablet in half) for first 2 weeks, then added 12.5mg in mornings. After 2 weeks
increased my night dose to 25mg and then 2 weeks later increased morning dose to 25mg. I’ve just increased my night dosage
to 37.5mg and will do the same with my morning dosage in another week until I reach 50mg morning and night.
I’m having problems with side effects so taking it very slowly and determined to stick with it as I’ve tried so many other med.s
with no luck so fingers crossed this maybe the one to help me.
sarah
Showing first signs of improvement now I’m on 75mg Topamax - thought it was never going to work for me! Had hoped the 75mg would be enough to clear things up - balance is now pretty good but visual vertigo, although improved somewhat, is still a problem so aiming for the 100mg.
nabeel
Which specialist prescribed the Topamax for you? Are you going to take the 100mg at night or some in the morning. Do you find the effect tapers off at all towards late afternoon?
Angela
Hope you’re not even more confused by all the different ways we manage our Topamax doses!!
Barb
barb
dr shaun watson prescribed the topa and no it does not wear off at night. i get symptim increase when i am tired no matter wat time of the day it is
barb that is awesome topamax is starting to help you, hope things keep getting better!
Hi Angela
I started on just 12.5mg and went up by 12.5mg approx every 4 weeks at night. I am now holding at 50mg (at night.)
I am about to increase again by 12.5mg but my neurologist has suggested that I add the increase in the morning, so I’ll now start adding 12.5mg every 4 weeks (in the morning) and keep taking my 50mg at night. I will end up on 50mg at night and 50mg in the morning.
I would have preferred to take it all at night but I was told that Topa works better if it remains stable in the system throughout the day.
It sounds like doctors all have different opinions!
How are you going so far Angela? It can be hard to start with but it gets easier when you stabilise on a dosage.
AG x
Thanks so much everyone for your tips and advice on taking topiramate. Life’s a bit mad at the moment (my dad terminally ill) and struggling a little so putting off taking something new even though I want and need to so badly. I will get a hold of myself very soon and go for it
Big hug Angela xx
Good luck Angela x
Hey there!
I take such a high dose so I take it all at night. I tried taking it during the day but it was bad…topa really has that drunk side effect bc when I dont take it my heads a bit clearer. Taking it all at night shouldnt be a prob. Its just the dose increase thats tough…hang in there!
BB
i have changed my timing 75mg at night to 25mg in the morning and 50mg at night with no real effect. will stick to this routine before upping my dose to 100mg soon probably in about two weeks. will probably try 50mg morning and 50mg night and try and bare with the side effects.