A few Topamax users have reported suicidal thoughts or have actually committed suicide. Warning labels indicate that patients on Topamax should be monitored for depression, increased anxiety, panic attacks, and other changes to mood or behavior. Topamax users are also at increased risk of experiencing difficulties with concentration or memory, as well as speech and language problems.
Fatigue, vomiting, and reduced mental alertness in Topamax users may be a result of a condition called hyperammonemia, which is an elevated level of ammonia in the blood. Some Topamax users have also experienced metabolic acidosis, a condition in which the body either produces too much acid or the kidneys cannot remove enough acid from the body. The condition can lead to brittle bones, kidney disease, slow growth in children, coma, or death.