Ebony Orbs - Just curious, what dose of Topamaxª (topiramate) are you taking?

I have had a few people come to me complaining of aches and pains after taking Topamax for awhile. I seem to remember that 3 different people phone me about this in one week; but I have only dealt with it sporatically since then. I did research the aches, trying to find something in common with those 3 people. Two of them were taking 200mg and the other was taking 300mg daily. All had been taking the drug for more than a month when they complained of aching.

One of the people said that it felt like when one has a cold or flu. The pain seemed to be more in the joints (more so than in the muscles; except lower leg muscles in one person) and was worse upon waking (ie. sort of a stiffness that had to worked out by moving around). Different parts of the body were affected in each of the three, but all had lower back pain and stiffness.

The week in which I got these 3 calls was in late summer and it had been raining most of the time (ie. high humidity). I had wondered if the humidity or air pressure (or the change in these) made the pains more noticeable, but I really didn't find that out.

All of them were taking their Topamax in one daily dose. I had them try to split the drug into 2 doses per day (ie. 100mg twice daily; and for the person taking 300mg, I had take 100mg in the morning and 200mg at bedtime). This seemed to help 2 out of 3; one had to stop taking the Topamax because of the aching.

I would hazard a guess that the Topamax may make normal aches and pains more noticeable. So, for you it may be that you may have the start of arthritis and the Topamax is exacerbating the condition. Before giving up on the drug, try spliting the dose (if possible). Also, you could try an anti-inflammatory/analgesic like ibuprofen (eg. Advilª, Motrinª, etc.; 600mg [3x200mg tabs] 3 times daily - maximum, relatively safe, dose is 600mg four times daily).

In other words, I am not really sure if it is the Topamax is causing your pain; but it is a good guess.

Topamax can cause changes in vision, as well. I have seen this in one person who had been taking the drug for about six months and had an eye test. The eye doc changed this person's eyeglasses prescription (worsening astigmatism, if memory serves me). Shortly after getting the new glasses the doc changed this person's meds from Epivalª (Depakoteª - divalproex) and Topamax to Epival and Lamictalª (lamotrigine) because of a worsening depression. The person's eyesight began to blur and when this person tried the old eyeglasses, the vision cleared again. Hmmmm......

Topamax has been known to cause nystagmus (jittery eyeballs) and this may result in diplopia (double vision). The dryness could have something to do with the eye changes, as well. Topamax can weakly inhibit carbonic anhydrase and drugs that block this (Diamoxª [acetazolamide] and Neptazaneª [methazolamide]) are used to treat glaucoma. This could contribute to the vision changes when taking Topamax.

As for the bleeding gums, dryness may be a part of the problem. Topamax is known to cause nose bleeds in a few people, but I have never seen this. The drug can also cause purpura, which usually manifests as bleeding into tissues causing purple spots (blood leaking into skin). These conditions may be caused by decreasing the body's ability to clot properly (possibly due to decreases in platelet levels). I would hazard a guess that this may be contributing to the bleeding gums. You could ask the doc to order a blood test to make sure that your platelet levels are normal.

As for the weather, we having been in the 30's C (high 70's, low 80's F) for about a month now. The motel I am staying at when working has no air conditioning. Being the Eskimo that I am, this is fairly uncomfortable. The only good thing is that my lawn isn't growing and there is a water ban on, so I don't have to cut it very often (it is messing up my wife's garden, though; this year I haven't even had to pee on the tomatoes to get rid of them - I hate tomatoes).

I hope that this is of some help to you. I really can't say that I am able to definitively answer your questions. The above is a bunch of educated guesses, rather than hard scientific fact. Sorry for that. - Cam

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