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Metabolic issues: Feeling constantly cold, chills, or a low body temperature (signs of metabolic acidosis) Severe gastrointestinal changes: Persistent diarrhea, vomiting, or a total loss of appetite Systemic changes: Unexplained tiredness, a fever or other signs of infection, unusual bleeding, bruising, or long-term concerns like osteoporosis In general, higher doses of topiramate are associated with an increased risk of adverse reactions

American Association of Clinical Endocrinologists

All secondary analyses were performed on complete cases of the full analysis set

Link Cox HD, Smeal SJ, Hughes CM, Cox JE, Eichner D

Strength 1 box- 10 sessions 4