This hyperammonemia and encephalopathy can develop with topamax treatment alone or with topamax treatment with concomitant valproic acid vpa .

Warn patients about the potential for somnolence, dizziness, confusion, difficulty concentrating, or visual effects, and advise patients not to drive or operate machinery until they have gained sufficient experience on topamax to gauge whether it adversely affects their mental performance, motor performance, and or vision see warnings and precautions .

Topamax may also be used for purposes not listed in this medication guide.

Topamax is listed by the fda as pregnancy category d, and may increase the risk of cleft lip and cleft palate in babies born to women taking topamax while pregnant.