The drug’ s most worrying side effect is the slight but serious risk for glaucoma, Dr. Green says, as topiramate has been associated with increased pressure inside the eye, which can lead to blindness if left untreated.
termine, was approved by the FDA for weight loss in July 2012.10)
THE DOWNSIDES
Though weight loss may be a welcome side effect for some, other side effects of topiramate are more concerning. Topiramate is linked to a long list of potentially negative side effects, from fatigue and anxiety to kidney stones and word-retrieval problems. 11
“ I jokingly call it Dopamax,” Havens says.“ I was foggy for months when I started using it.”
While on the drug, Havens says she will occasionally have trouble thinking of the right words to say, but the effect has largely faded over time. Word retrieval is a particularly frightening cognitive side effect of the drug, Dr. Green says.
“ It makes you a little loopy— I don’ t think I’ m as sharp a thinker when I take it,” says Anne Brinkley, a retired
North Carolina high school chemistry teacher who had to retire early due to incapacitating migraines.“ It’ s a tradeoff. I’ d rather not think as well than have more migraines.”
The drug’ s most worrying side effect is the slight but serious risk for glaucoma, Dr. Green says, as topiramate has been associated with increased pressure inside the eye, which can lead to blindness if left untreated.
But overall, the most common side effects are less alarming. About onethird of patients in one trial complained of paresthesia, the most common side effect, which involves a pins-and-needles feeling in the hands and feet. 8 The tingling does not damage nerves and resolves in most patients, Dr. Green says. In that same trial, some 17 percent of patients complained of fatigue, 11 percent said their sense of touch was blunted and about 10 percent experienced nausea. Perhaps most frustrating, many of these side effects appear before the drug’ s benefits start, Dr. Green says.
These side effects make it even more important for physicians to use a“ start low / go slow” approach to treatment, easing patients up to their effective dose, Dr. Green says, adding that most side effects disappear over time.
BIRTH DEFECT DILEMMA
Topiramate could also have worrying side effects for the unborn. In May 2011, the FDA announced an association between topiramate exposure during pregnancy and increases in certain types of birth defects. The agency found
10. FDA.“ FDA Approves Weight-Management Drug Qsymia.” Press release. July 17, 2012. 11. Drugs. com.“ Topiramate Side Effects.” 2012.
34 HEAD WISE | Volume 2, Issue 4 • 2012