I've been on topamax for about four years in varying dosages, now at 75mg a day split between morning and night. For the last couple of years I've been struggling more and more with some thought processes and am wondering how much of it is a side effect. I'm trying to address it with my dr but a long time lapses between appointments.

one thing is that i have problems spelling things out while writing them down. at work i often have to write people's names and when they spell them out i often can't tell what the letters are unless i memorise it quickly and then slowly repeat it back in my head. i usually end up guessing what the letters are because they don't make sense. l and m and n and a and e often all sound the same/get confused. despite lowering the dose of the topamax at some point this has continued.

another thing that has only started recently is forgetting words, forgetting what to say, or just saying nonsense. like i've said "okay" instead of "good day", mixed up words and just plain made up words sometimes. this is also making work a bit stressful - like if i answer the phone i really have to concentrate on what i'm saying.

can side effects like this actually get worse over time even though my dose has actually gone down?