The worldwide challenge of the dementias: a role for B vitamins and homocysteine
These letters contributed to the significant uptick an increase of 50% overall in the number of CDER warning letters issued in FY 2025
Maximum doses reach 400 mg daily, with monitoring for side effects like drowsiness or cognitive difficulties. Adult Dosage for Seizures Start at 25 mg once daily, titrating to 200 mg twice daily (400 mg total) alone or with other drugs for focal onset or tonic-clonic seizures. Dosage for Migraine Prevention Begin at 25 mg daily for one week, increasing to 50 mg twice daily after titration to prevent migraines effectively. Pediatric Dosage Considerations Weight-based dosing starts at 1-3 mg/kg daily up to 25 mg, split into two doses, with maximums like 250-400 mg based on body weight for children. Side Effects and Warnings of Topamax Common side effects of Topamax include weight loss, tingling sensations (numbness or burning), cognitive difficulties like speech problems or confusion, nausea, fatigue, and decreased appetite
Then theres the issue of the drug not held to the high safety standards as TGA-approved products
26 METABOLIC-BARIATRIC SURGERY Metabolic-bariatric surgery and endoscopic procedures modulate gut hormones (eg, GLP-1, peptide YY, ghrelin), improve insulin sensitivity and mitochondrial function, and reshape the gut microbiome, all of which contribute to decreasing hepatic steatosis