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User beware!  I have suffered from migraines for over 20 years and took Topamax for 4-6 months a couple years ago.  I too slowly increased my dosage to 200 mg daily.  For me the negative side effects outweighed the good ones.  I must admit that I was happy to have lost 30-40 lbs since nothing tasted quite right to me while taking it.  My headaches improved slightly (a bit further apart), but continued to be just as painful when they occurred.  I was no longer able to drink any carbonated beverages, as they all tasted like chemicals.  I stopped taking the medicine due to the constant nausea and occasional vomiting.  Oh, I should also mention the blurry vision problems and mental blankness.  I could hardly carry on an intelligent conversation and felt kind of spaced out.  I suggest you pay close attention to your body while taking Topamax.  All of the drugs have their own set of side effects for each person.  I guess it's a tradeoff of sorts.  You might try Feverfew supplements (with Butterbur) or Feverfew herbal tea.  I find they both help a bit with migraine prevention, but I keep the Imitrex, Midrin, and Compazine standing by just in case.