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Compare Topamax vs. Lamictal

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Topiramate (Topamax, Qudexy XR, Trokendi XR, Eprontia) and lamotrigine (Lamictal) are both antiepileptic medications used to treat seizures, but they have some key differences. Topiramate can also be used to prevent migraines, while lamotrigine can be used for bipolar disorder. Topiramate is available in both immediate-release and extended-release forms, as well as a liquid solution, making it versatile for those who have trouble swallowing pills. Lamotrigine also comes in various forms, including chewable and quick-dissolving tablets, as well as extended-release tablets. Topiramate can cause kidney stones and serious eye problems, while lamotrigine can increase the risk of severe skin reactions and the potential for brain inflammation (meningitis). Both medications are available as low-cost generics and interact with other medications, including birth control pills.

Topiramate
Lamotrigine (Lamictal)
Topiramate
Lamotrigine (Lamictal)
Summary of Topamax vs. Lamictal
Summary for Antiepileptic
Prescription only
Topiramate is a prescription medication that can be used alone or in combination with other medications to treat certain types of seizures. It can also be used to prevent migraines. It comes in immediate-release and extended-release tablets and capsules, as well as a liquid. Topiramate is typically taken by mouth once or twice daily, depending on what formulation you're using. Some forms of topiramate are available as lower-cost generic medications.
Summary for Antiepileptic
Prescription only
Lamotrigine (Lamictal) can be used alone or together with other medications to treat seizures. It's available in immediate-release and extended-release formulations. The immediate-release formulation can also be used for bipolar disorder. Lamotrigine (Lamictal) can cause serious skin reactions like rash.
Indications of Topamax vs. Lamictal
Indications for

•Seizures (partial seizures, tonic-clonic seizures, Lennox-Gastaut syndrome)

•Migraine prevention

Indications for

•Seizures (partial seizures, tonic-clonic seizures)

•Seizures of Lennox-Gastaut syndrome - immediate-release only

•Bipolar disorder - immediate-release only
Pros and Cons of Topamax vs. Lamictal
Pros and Const for Antiepileptic
Pros

•Can be used on its own or with other medications to control seizures

•Available in short-acting and long-acting forms, so options to take once or twice daily

•Available as a solution (Eprontia), so it's convenient for people who have trouble swallowing

•Can be used to treat different types of seizures

•Can be used to treat seizures in both adults and children

Cons

•Can prevent migraines from happening, but it won't help if you have a migraine attack

•Can cause kidney stones

•Can cause serious eye problems

•Interacts with many medications, such as warfarin (Coumadin), phenytoin (Dilantin), and divalproex (Depakote)

•Children taking this medication for long periods of time will need to have their doses adjusted often due to changes in body weight as they grow

Pros and Const for Antiepileptic
Pros

•Starter kits are available to help with dosing when you first start the medication.

•Dose can be adjusted based on your response

•Available in various forms: chewable tablets, quick-dissolving tablets, and extended-release tablets

•Available as a lower-cost generic

Cons

•Can cause dizziness

•Dose has to be slowly raised due to risk of serious rash

•Interacts with many medications such as birth control pills, divalproex (Depakote), and dofetilide (Tikosyn)

•Unknown if safe or works well in children under 2 years old (immediate release) or children under 13 years old (extended release)
Common Side Effects of Topamax vs. Lamictal
Common Side Effects for
Please note: These are common side effects reported by children and adults who took immediate-release topiramate. Frequency of side effects can differ based on your age, as well as the dose and formulation of topiramate you're taking.

•Feeling "pins and needles"

•Drowsiness

•Weight loss

•Nervousness

•Fatigue

•Dizziness

•Lack of appetite

•Trouble sleeping

•Upper respiratory tract infection (e.g., cough, stuffy nose, sore throat)

•Fever

•Change in taste

•Trouble moving or keeping balance

Common Side Effects for
Below are common side effects reported by adults who took this medication along with other treatments. Percentages can differ depending on your condition (e.g., bipolar) and your age.

Immediate release

•Dizziness (38%)

•Headache (29%)

•Double vision (28%)

•Loss of coordination (22%)

•Nausea (19%)

•Blurry vision (16%)

•Sleepiness (14%)

•Stuffy nose (14%)

•Sore throat (10%)

•Rash (10%)

Extended release

•Dizziness (14%)

•Nausea (7%)

•Vomiting (6%)

•Tremor (6%)

•Feeling tired (6%)

•Double vision (5%)

•Diarrhea (5%)
Warnings of Topamax vs. Lamictal
Common Side Effects for

•Vision problems

•High body temperature and trouble sweating

•Higher level of acid in blood

•Suicidal thoughts or behavior

•Problems with mood and thinking clearly

•Higher ammonia level in blood

•Serious birth defects

•Skin reactions

•Withdrawal seizures

•Interaction with other medications

Common Side Effects for

•Severe skin reactions and allergic reactions

•Overactive immune system

•Irregular heartbeat

•Suicidal behavior and thoughts

•Meningitis (brain inflammation)

•Withdrawal seizures

•Possible eye problems

•Interaction with other medications
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Key takeaways

Summary of Topamax vs. Lamictal

Indications of Topamax vs. Lamictal

Pros and Cons of Topamax vs. Lamictal

Common Side Effects of Topamax vs. Lamictal

Warnings of Topamax vs. Lamictal

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