Topiramate is an anticonvulsant and nerve pain medication that was initially developed to treat epileptic seizures. Since then, it has also been used to treat migraines, bipolar disorder, and to help people recover from alcohol, cocaine, and opioid addiction by stabilizing mood, reducing cravings, and preventing seizures during detox.1
Topiramate is only legally available with a valid prescription but it is not classified as a controlled substance in the U.S. It’s available in 25 mg, 50 mg, 100 mg, and 200 mg tablets, as well as 15 mg and 25 mg capsules that can be swallowed whole or broken and sprinkled over food and consumed that way. Typically, it is prescribed to be taken twice daily, but the dosage can vary depending on the reason for taking it.
Topamax, also known as topiramate, is an anticonvulsant medication that is used to treat epilepsy and prevent seizures. It is also used to prevent migraine headaches. While Topamax can be effective for these conditions, some people consider stopping the medication, either to switch to something else or to stop treatment altogether. A common question is: can you stop taking Topamax cold turkey?
The short answer is no, you should never stop taking Topamax suddenly without medical supervision Quitting Topamax cold turkey can lead to serious withdrawal symptoms and consequences. In this article, we’ll explain why stopping Topamax abruptly is dangerous, the proper way to stop Topamax, and the withdrawal symptoms you may experience.
Why Stopping Topamax Cold Turkey is Dangerous
Topamax affects important brain chemicals like glutamate and GABA that are involved in sending signals in the brain. When you suddenly stop taking Topamax the brain is thrown off balance as levels of these neurotransmitters change rapidly. This disruption can trigger seizures even in people who didn’t take Topamax for epilepsy.
Other serious cold turkey Topamax withdrawal symptoms include:
- Loss of coordination and control of body movements
- Severe dizziness and vertigo
- Extreme nausea and vomiting
- Blurred or double vision
- Rapid heart rate and palpitations
- High fever
- Confusion and psychosis
For people who do take Topamax for epilepsy suddenly quitting greatly increases the risk of recurrent seizures that won’t stop on their own. Status epilepticus a state of continuous seizure activity, can lead to brain damage or even become fatal.
As you can see, stopping Topamax abruptly carries serious health risks. It should never be done without direct medical supervision in case intervention is needed.
The Proper Way to Stop Taking Topamax
To safely stop taking Topamax, you need to taper off it very slowly under a doctor’s direction. This gives your brain and body time to readjust to functioning without the medication. Quitting Topamax overnight is never advised.
Your doctor will have you gradually decrease your Topamax dose over a period of weeks to months. They’ll recommend a tapering schedule based on factors like:
- Your starting Topamax dosage
- How long you’ve taken Topamax
- Reason for using Topamax
- Your health status
For example, one typical tapering plan may have you reduce your daily Topamax dose by 25-50 mg each week. However, your doctor may suggest a different tapering rate that’s appropriate for your situation.
During the Topamax taper, your doctor will monitor you closely for any withdrawal symptoms or side effects. They may adjust the tapering schedule if needed – such as slowing it down if symptoms are too severe. Patience is key for a safe Topamax withdrawal.
Topamax Withdrawal Symptoms
Quitting Topamax cold turkey is dangerous, but tapering off slowly can still cause some withdrawal symptoms. Possible Topamax withdrawal side effects include:
Rebound seizures – Seizures often return when stopping Topamax, especially if it’s stopped suddenly. Slow tapering aims to minimize recurrence.
Dizziness and vertigo – These disturbing sensations are very common. Room spinning and loss of balance can make standing or walking difficult.
Nausea and vomiting – Upset stomach and throwing up frequently affect over half of people tapering off Topamax.
Vision problems – Blurred vision, double vision, and rapid involuntary eye movements are possible.
Tingling sensations – Abnormal prickling or numbness in the hands, feet, arms, legs, face, mouth, or tongue.
Mood changes – Irritability, anxiety, sadness, crying spells, and depression may arise or worsen.
Cognitive issues – Trouble concentrating, confusion, speech issues, and slowed thinking.
Insomnia – Difficulty falling and staying asleep is common.
Loss of appetite – Some experience a reduced desire to eat and weight loss.
Fatigue – Feeling extremely tired and having low energy are frequent complaints.
Body aches – Generalized pain and muscle soreness may occur as well.
Stay in close contact with your doctor if you experience any uncomfortable or concerning symptoms when tapering off Topamax. They may be able to provide supportive treatments to ease the withdrawal process.
The Takeaway – Never Quit Topamax Cold Turkey
While Topamax can effectively control seizures and migraines, stopping the medication may be necessary in some cases. However, quitting Topamax cold turkey is extremely dangerous and puts you at high risk for seizures, physical harm, and even death in severe cases.
Always talk to your doctor first before making any changes to your Topamax regimen. They’ll supervise a gradual tapering schedule that allows you to safely withdraw from Topamax over weeks to months. Withdrawal symptoms may still occur but can be managed under medical oversight. Patience is essential to avoid negative health consequences when discontinuing Topamax.
Topiramate for Addiction Treatment
Due to the way topiramate works in the body, research has found that it shows great promise for treating addiction. Despite the evidence, the FDA hasn’t approved topiramate for treating drug or alcohol addiction. However, nothing is preventing medical doctors from prescribing it for those purposes.
Several recent studies have provided evidence that topiramate, used in conjunction with therapeutic interventions like counseling, may help people overcome various types of drug addictions.
- Alcohol addiction treatment with topiramate: A study from the American Journal of Psychiatry offers evidence that topiramate can be used with counseling to help people reduce heavy drinking. However, the study demonstrated these results among people who were wanting to cut back on their drinking, not stop completely.2
- Cocaine addiction treatment with topiramate: Cocaine is a notoriously difficult addiction to treat, but one study from JAMA Psychiatry found that topiramate showed great promise. According to the study, a maintenance dose of 300 mg of topiramate helped people with cocaine addiction reduce the average number of times they used cocaine over the course of a week.3
- Nicotine addiction treatment with topiramate: Another study from the journal Nicotine & Tobacco Research found that topiramate was effective for smoking cessation, although further research is still needed to confirm the results.4
- Opioid addiction treatment with topiramate: One study found that topiramate may also be effective in reducing the severity of opioid withdrawal among people who are struggling with opioid addiction.5
There have not been any studies on whether topiramate can cause dependence, but it may be possible.6 Unlike many other drugs of abuse, topiramate won’t make you feel high. Instead, you’re more likely to feel sleepy, dazed, or a little bit confused. It won’t produce feelings of pleasure, excitement, or happiness.
If you take topiramate without a prescription or misuse it with other substances, you may be more likely to develop a topiramate addiction. Taking too much topiramate can also increase your risk of overdose. Even if you take topiramate as prescribed by a doctor, you may still become psychologically or physically addicted.
Although topiramate does not have a high risk of abuse or dependence, you can do certain things to reduce your risk of topiramate addiction and overdose, such as:
- Not taking anyone else’s prescription topiramate.
- Not taking higher doses than your doctor prescribed.
- Not using topiramate with any other addictive substances or prescription medications without consulting your doctor first.
What Are the Signs and Symptoms of Topiramate Addiction?
Topiramate addiction is rare and the drug doesn’t have a high risk of abuse or dependence. However, if you think you might be addicted to topiramate, there will be signs and symptoms.
Some common signs of topiramate addiction may include:
- Being preoccupied with taking topiramate
- Visiting multiple doctors to get more than one prescription for topiramate
- Lying to friends or loved ones about taking topiramate
- Continuing to misuse topiramate despite the harmful physical side effects and emotional problems
- Experiencing symptoms of topiramate withdrawal after missing a dose
5 Substances You Can’t Quit Cold Turkey
FAQ
What happens if you stop Topamax suddenly?
Does Topamax have to be tapered?
Do you have to wean Topamax?
Will I gain weight after stopping Topamax?
Can I stop taking topiramate cold turkey?
Never stop taking topiramate cold turkey. Set up a meeting with your doctor to gradually lower your Topamax dose if you are interested in discontinuing your topiramate treatment. Lowering your Topamax over time will help you avoid enhanced, unwanted topiramate withdrawal symptoms. This will also help you safely detox from topiramate.
When should I stop taking Topamax?
Only stop Topamax suddenly if your doctor tells you to. Your doctor can determine the best way to slowly stop your medicine to lower your risk for a seizure. Never stop taking Topamax suddenly, or “cold turkey”, because this may cause you to have an increased risk of seizures, more frequent seizures, or other serious withdrawal symptoms.
Can I stop taking Topamax If I have epilepsy?
Never stop taking Topamax suddenly, or “cold turkey”, because this may cause you to have an increased risk of seizures, more frequent seizures, or other serious withdrawal symptoms. This can happen even if you do not take Topamax for epilepsy. Topamax is also approved by the FDA to be used in patients to help prevent migraine headaches.
What happens if I miss a dose of Topamax?
Don’t take a double amount to make up for a missed dose. Don’t stop taking Topamax suddenly, as that may cause seizures, even if you haven’t had them in the past. If you need to stop taking Topamax, your doctor will gradually decrease your dose to safely wean you off the medication.