I went onto Topamax last year and almost died. Following the graduated increase schedule, every time my body came close to acclimating to the drug, the new dose would hit it like a ton of bricks. By the time I had reached the target dose, I was scarcely able to think, had difficulty getting out of my chair, and couldn't focus my eyes.
The schedules do not work for everybody. I was an idiot. My (former) doctor was too difficult to communicate with.
When I finally got it right, it was a tiny dose. Beats the daylights out of Depakote.