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But medication response varies, and impulse-control skills may still need to be developed through coaching, therapy, structure, and practice
Common side effects include: Cognitive slowing, including difficulties with memory, concentration, and word-finding Fatigue and drowsiness Dizziness and coordination problems Paraesthesia (tingling sensations, particularly in the hands and feet) Decreased appetite and weight loss Mood changes, including low mood, depression, and irritability More serious risks include: Metabolic acidosis topiramate inhibits carbonic anhydrase, which can reduce blood bicarbonate levels
Vial duration by dose But remember the 28-day rule
It is included on the 2026 WADA Monitoring Program alongside semaglutide, allowing WADA to gather data on GLP-1 receptor agonist use patterns ahead of a possible Prohibited List decision by late 2026 or 2027
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