I've been on Topamax for several months now at 200mgs and have had no adverse side-effects. Were it not for Topamax and a supplemental 50mgs of Amitriptylene at bed time I would be in a perpetual migraine state. Topamax controls the migraine response and helped me drop 10 lbs too! The only side effect I've experienced is "pins & needles" in the extremities, but these episodes are infrequent and, when they do occur, last only a few seconds. I feel awful for those who have had a sub-standard experience with this one because it has been really good to me.