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The first is the titration period, roughly the first 16 weeks while your dose steps up every four weeks

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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

It works in different ways: When your blood sugar is high, it stimulates the release of insulin

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