I am 43, and have been on 200 mg of Topamax at night for over 8 years. I have not gained any weight, and it has helped a LOT with migraines (I used to get them all the time). Since I am also a heart patient, I can't use Imitrex or any of the new migraine medicines. It has worked as a mood stabilizer for all this time, the most effective one we've found, with the least side effects. Although after long term use, it does tend to affect your memory and your balance. But overall, I find those minor annoyances compared to what I'm like off it.I haven't found anything that works completely, but it's as close as I've come.