Medically reviewed article

Treatment with Topiramate, also known as Topimax

Topiramate is used as a preventive medication for migraines

By
Hemi Health
Hemi Health

The preparation

Topiramate was developed to treat epilepsy, but scientific studies have shown that it can also be effective for migraines.

Effect

Topiramate stabilizes electrical activity in the brain. This is likely why it has a preventive effect on migraines. Topiramate does not eliminate migraines. A realistic treatment goal is to halve the number of attacks. For some, more; for others, less.

Side effects

The most common side effects are tingling in the hands, nausea, and slight weight loss. Fatigue, dizziness, reduced concentration, difficulty finding words, and depression may also occur. In rare cases, kidney stones can develop. High doses may reduce the effectiveness of birth control pills.

Precautions

It is important not to become pregnant during treatment with topiramate, which is why barrier contraception (e.g., condoms) is recommended.

Before starting treatment

Before you start treatment, blood tests must be taken to check your electrolyte levels.

What is the dosage?


Uge Morgen Aften Døgndosis
1-2
- 25 mg 25 mg
3-4 25 mg 25 mg 50 mg
5-6 25 mg 50 mg 75 mg
7-frem 50 mg 50 mg 100 mg

‍

Normalt starter man med at tage 25 mg en gang dagligt i 14 dage. Herefter skal man stige med 25 mg hver 14. dag fordelt på 2 doser, indtil man når op på 50 mg morgen og 50 mg aften (det vil sige døgndosis på 100 mg). Det er den sædvanlige vedligeholdelsesdosis. Enkelte har god effekt ved døgndoser på 50-75 mg. 

Ved manglende effekt, og hvis der ikke er generende bivirkninger, kan man efter en måned stige til 100 mg morgen plus 50 mg aften i 2 uger og herefter til 100 mg to gange dagligt (det vil sige døgndosis på 200 mg). 

Hvis der ikke er effekt af denne dosis efter cirka 2 måneder, kan det konkluderes, at topiramat ikke virker på dig. Du skal så trappe ned med 50 mg per uge, indtil du er helt ude af medicinen

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