I started with 25 mg for migraines and upped dosage by 25mg pweek for 4 weeks till I reached 100 mg per day. Right away this didnt work because you cant half the pills because the taste will kill you. but once I adjusted to the 50 mg it was ok. There are side effects. I have cured my life long addiction to coca cola. I can no longer drink soda, it tastes gross, really vile, and I have lost almost twenty pounds sfter one month. The no soda gave me incentive, so I have been dieting, but the topamax only seems to help. I have only had one migraine this month, on the monring of my periods arrival. This hasnt happened in twenty years. Ive been on all sorts of meds throughout the years. I love topamax. I have had some other side effects. I am diagnosed as bipolar, and do not take medicine because the depakote made me a zombie. Life has been much easier, although on the days I up my dosage I was a bit hyperemotional. Nothing too bad though. I was, however, unable to drink two glasses of wine on this medication. I did have some spacey moments, and tingly fingers as well. Like I said before, nothing compared to Depakote, and nothing that I wouldnt trade for ONe hormonal migraine a month. I love this stuff.