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Common side effects of Topamax include: diarrhea, paresthesia, nausea, ataxia, lack of concentration, diplopia, nervousness, dizziness, memory impairment, speech disturbance, anxiety, dysphasia, drowsiness, psychomotor disturbance, confusion, fatigue, visual disturbance, weight loss, depression, dysgeusia, mood changes, and anorexia.
1 The key to success with Topamax is a very slow titration up to the therapeutic dose. Patients should begin taking only 15 mg, once a day, and taper up slowly from there, being sure to take it in a split dose..  The effective dosages are lower than you might think.