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Topiramate Addiction: Side Effects, Detox, Withdrawal, and Treatment

Table of contents

What is Topiramate?

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.

Common brand names for topiramate include:

  • Topamax
  • Quedexy XR
  • Trokendi XR

How Does Topiramate Work?

Topiramate works by interacting with gamma-aminobutyric acid (GABA) in the body and changing the way the nerves communicate with one another. Essentially, it decreases abnormal excitement in the brain. 


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

Is Topiramate Addictive?

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 Side Effects of Topiramate Abuse?

Topiramate can produce some mild or severe negative side effects when it’s taken as prescribed. These may include: 

  • Tingling sensations
  • Fatigue
  • Difficulty concentrating
  • Nausea
  • Insomnia
  • Abdominal pain
  • Constipation
  • Vision problems
  • Shortness of breath
  • Heart problems
  • Seizures
  • Migraines

Generally, any mild side effects you experience when you start taking topiramate will go away in a few weeks. (If they don’t, you should call your doctor.) However, if you misuse topiramate or use other prescription drugs or illegal drugs with topiramate to enhance its effects, you may experience more severe side effects as a result.7


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

What Are the Symptoms of Topiramate Withdrawal?

Common topiramate withdrawal symptoms may include:

  • Trouble concentrating
  • Anxiety
  • Confusion
  • Sweating 
  • Depression
  • Dizziness
  • Insomnia
  • Irritability
  • Headaches 
  • Mood swings
  • Nausea
  • Seizures

Not everyone will experience topiramate withdrawal in the same way. The type and severity of someone’s topiramate withdrawal symptoms can vary depending on: 

  • Their substance use history
  • Individual factors like metabolism
  • The method they use to quit taking topiramate (cold turkey or tapering)

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    How Long Does Topiramate Stay In Your System?

    The half-life of topiramate is about 20 to 30 hours and it will stay in your system for about four to six days after your last dose, depending on individual factors and your dosage.8 These timeframes vary depending on individual differences in metabolism and other factors.


    How To Stop Taking Topiramate

    You should never stop taking topiramate suddenly. Doing so could cause you to have seizures, even if you’ve never had them before. Instead, the best way to stop taking topiramate is to talk with your doctor about it. He or she will probably gradually reduce your dosage and taper you off the drug to reduce severe topiramate withdrawal symptoms.

    If you feel like you’re addicted to topiramate, you can also complete a specialized topiramate detox program at a detox center. Completing topiramate detox at a specialized facility can provide round-the-clock medical monitoring, clinical care, and medication-assisted treatment to make sure you are safe and comfortable during topiramate withdrawal.

    A topiramate detox program will help you safely stop using the drug and reduce the severity and duration of the withdrawal symptoms you experience. After you complete topiramate detox, you’ll be one step closer to living a happy drug-free life.


    Topiramate Addiction Treatment Options

    Upon completing topiramate detox, many people may choose to complete a rehab program to address the underlying causes of their addiction. Although detox is an important first step to sobriety, it’s not the only step in the recovery process. Ongoing treatment in a residential or outpatient rehab program is often essential for a full and lasting recovery from topiramate addiction.

    If you’re looking for a topiramate rehab program, there are several differences between residential rehab and outpatient rehab. The chart below outlines those primary differences.


    During residential topiramate rehab clients:
    Live at the topiramate rehab center while they complete their treatment program.Adhere to all the rules set forth by the staff at the topiramate treatment center.Attend various types of therapy sessions, process groups, and recovery-related activities at the rehab center.Have limited access to the outside world, although visits with friends and family members can be arranged.

    During outpatient topiramate rehab clients:
    Live at home or in a sober living home while they complete their treatment program.Adhere to all the rules set forth by the staff at the sober living home and maintain abstinence from drugs and alcohol.Attend group therapy sessions and process groups several times a day or week at an outpatient location.May continue working, going to school, or tending to responsibilities at home while they complete treatment.

    Depending on whether you choose a residential topiramate rehab program or an outpatient topiramate rehab program, the cost of treatment can vary greatly. Cost also varies from facility to facility due to factors like amenities, location, and treatment services offered.

    Most topiramate treatment programs will accept health insurance benefits, which may help you pay for both detox and rehab. Depending on the type of health insurance policy you have, your insurance may cover a portion of topiramate treatment at detox and rehab centers.

    If you don’t have health insurance, you may be able to utilize other payment options for topiramate treatment, including:


    What Are Continued Care Options for Topiramate Addiction?

    After you complete a topiramate rehab program, you might also want to continue your treatment with a supportive sober living program or aftercare program. These types of topiramate treatment programs offer continued support and structure after treatment in rehab to help you adjust to a sober life, deal with triggers, and create new, healthy relationships.

    Sober Living Programs

    Sober living programs provide sober homes for men and women who are recovering from drug and alcohol addiction. These sober homes are substance-free, structured living environments that also offer structured recovery programming, such as:

    • Regular drug and alcohol testing
    • Certified peer recovery support programs
    • Phased and individualized recovery programming
    • Employment assistance
    • Volunteer placement
    • Educational planning
    • Access to IOP and clinical care services through a third-party provider

    If you have health insurance, it likely won’t cover the cost of a sober living program. However, most sober living homes are affordable living options and some facilities offer scholarships for incoming residents who need financial assistance.

    Aftercare Programs

    After completing a formal topiramate treatment program, you may also find that transitional life circumstances are more difficult sober. Examples might include moving across the country, getting a divorce, or losing a job. These circumstances are often very difficult for anyone to handle, but people in recovery may have an especially difficult time coping without falling back on drugs or alcohol.

    Aftercare programs are comprised of weekly group meetings led by a licensed counselor or recovery specialist at an outpatient facility. The topics of group discussions may vary but are often centered around addiction, recovery, and personal growth. 

    Clients in aftercare receive recovery support and accountability from their peers. By attending group therapy regularly, they also have additional opportunities to improve their confidence, enhance their self-awareness by listening to the experiences of others, and practice their communication skills.

    If you or a loved one is struggling with topiramate addiction, help is available now. Misusing any type of prescription drug like topiramate can have devastating consequences, but you don’t have to continue suffering. Please call (512) 605-2955 today to speak with a Nova Recovery Center representative.

    References:

    1. https://www.accessdata.fda.gov/drugsatfda_docs/label/2009/020505s038s039,020844s032s034lbl.pdf
    2. http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2013.13081014
    3. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/1756816
    4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3920334/
    5. https://pubmed.ncbi.nlm.nih.gov/16172090/  
    6. https://www.medicalnewstoday.com/articles/topamax
    7. https://www.drugs.com/sfx/topiramate-side-effects.html
    8. https://pubmed.ncbi.nlm.nih.gov/9264038/

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