Q. Does Topamax cause complete lack of sexual desire? And I do mean complete!
A. Topamax (topiramate) is prescribed for epilepsy, but it is also used to prevent migraine headaches. Your short question implies a lot of frustration and sent us hunting for an answer.
“Decreased libido” has been reported as a side effect of Topamax in the prescribing information provided for doctors. It seems not to be very common, though, affecting just a few patients in a hundred.
Doctors have also described cases in which Topamax completely blocked women’s ability to achieve orgasm (Neurology, Oct. 25, 2005). About five days after discontinuing the Topamax under medical supervision, the women were once again able to climax.
Never stop an epilepsy drug suddenly without your doctor’s approval. An unexpected seizure could be devastating.
Mel
Wow I guess I figured out why sex interest me in the least. I take 125 mg of topamax twice a day.
JLJ
Have you had your icp checked? Daily headaches plus migraines sound a lot like what I had when they diagnosed me with Ideopathic intracranial hypertension (what used to be called pseudotumor cerebri). If they haven’t checked your ICP or your eyes, just for giggles, you might have ’em do that. I got a shunt put in (fought for three years to get it) and most of the headaches went away.
debbie
I am on topomax for one month 25mg..I am a 50 year old youthful woman who enjoyed an amazing sex life … until now. I have suffered vaginal dryness the last two weeks and sought gynecological help thinking yeast infection..but nope..with no diagnosis of anything. I am thinking the only thing I have done differently is begin taking topomax. I see others talking about orgasm on here but what about vaginal dryness? Painful intercourse and the burning is hell and making life hell! My gyno gave me estrogen creme blaming menopause, but it’s doing nothing after daily use. Someone help! !
nina
Please explain the burning. I have an idea but I’m losing my mind here.
Jeremy
My wife has just recently started using Topamax again. We went from an awesome relationship and fabulous sex to fighting and abstinence. When she was on it before, it was the same thing… absolutely no interest in any advance that I made and arguments arising out of thin air.
This drug has made a great relationship between two best friends become bitter and stale. Avoid this drug at all costs if you can. If you must take it, sit down and discuss it with your spouse and the possible effects it will have on your relationship. It was difficult, and I felt shallow, but I talked to my wife about it and told her that no sex flat out sucked. Talking about it has improved our relationship, but not our sex life.
It’s to the point that I think that there is something wrong with me (shallow, one track mind) because lack of sex (none) has caused so much of a problem.
I’m 34 years old and I have a STRONG drive, but she has no interest at all. I wish there was something else she could take for migraines, but for now we have to live with it…. For better or for worse in sickness and in health, I love you baby.
Jeremy
My wife has just recently started using Topamax again. We went from an awesome relationship and fabulous sex to fighting and abstinence. When she was on it before, it was the same thing… absolutely no interest in any advance that I made and arguments arising out of thin air.
This drug has made a great relationship between two best friends become bitter and stale. Avoid this drug at all costs if you can. If you must take it, sit down and discuss it with your spouse and the possible effects it will have on your relationship. It was difficult, and I felt shallow, but I talked to my wife about it and told her that no sex flat out sucked.
Talking about it has improved our relationship, but not our sex life. It’s to the point that I think that there is something wrong with me (shallow, one track mind) because lack of sex (none) has caused so much of a problem. I’m 34 years old and I have a STRONG drive, I could go for two-a-days…. but she has no interest at all, at least she can’t use the excuse, “honey, my head hurts”. That may have seemed insensitive, but it was for comical purposes only!
I wish there was something else she could take for migraines, but for now we have to live with it…. For better or for worse in sickness and in health, I love you baby.
A.G.
I get daily headaches along with migraines at least 1-3 times a week. I have been taking topamax for about 7 months now. 50 mg in the morning, and 100 at night. Along with Immitrix and butalbital when I really need it. After about 3 months I couldn’t orgasm, and now I have a difficult time getting excited at all. I’ve only been married a little over a year and find it very frustrating! There has to be a solution out there somewhere.
Sarah
I am 20 years old. I take Topamax for Bipolar I disorder. I started taking Topamax about 3 months ago in November 2012. In the beginning I took 25mg in the day and 25mg at night. Then mid-December increased the dosage to 200mg a day total. My psychiatrist increased my dosage of Topamax and prescribed 25mg of Adderall the same day (I had already been diagnosed w/ ADHD a year prior, I switched doctors, I had never tried Adderall before). Soon after the increase in Topamax, she had to decrease it because it was causing blurry vision and extreme pupil dilation.
I CURRENTLY take 50mg in the day and 50mg before bedtime. I’ve been taking this current dosage for 3 weeks. At first I thought it was stupid of her to up the dose of the Topamax AND give me a highish dose of Adderall on the same visit. But it just dawned on me yet again she’s the best psychiatrist I’ve had. The Adderall got me off my butt and I completely changed my lifestyle and made me productive. And I realized that YES!! The Topamax stabilized my moods even better, but also I have absolutely NO INTEREST IN SEX AT ALL THANK YOU JESUS ALMIGHTY!! I am 20 years old, I don’t need to be having sex or focusing on guys. I need to figure myself out first and focus on school and priorities.
Julie
After suffering a severe car accident at the age of 19, I have been suffering from terrible migraines. Tried many medication, and I eat a very healthy diet. My Dr. says I am the worst patient she has ever treated. I am now taking Topamax twice daily at a very high dose of 250mg/per day. In combination with Nadolol 160mg daily and Nortriptyline 40mg as well.
I’ve experienced the lack of appetite and loss of weight with Topamax. My short term memory has been affected and numbers are not my best friend. My hands and extremities are numb 20 after ingesting the Topamax. No issues in the bedroom… And yes I still experience migraines, but they are not as severe, I can now function.
kp
Took Topamax (100) for over 3 years with no adverse effects, but then had to stop for another two years because of other medical issues. I just started working back up to my former dosage this week and my libido has flown the coop in what was an exciting sex life just last week! I’m told it may just be a period of (re)adjustment.
Sandra
Sandra I have been on topamax since February 2012 for bi polar I think it’s absolutely great. My libido is great too. I feel wonderful. I have lost 40 lbs. and continue loading weight due to working out and topamax. I take 50 mg am and 50 mg at night. It’s doing wonders. My sexual life at age 45 can not be better. I guess it’s different for everyone. Also it might be different depending on your metabolism and the milligrams you are taking. Plus if you are taking other medications besides this one that might be the cause of other negative side effects.
Pamela
I’ve been taking Topiramate 50 twice a day for migraines. The tingling fingers and nausea I’ve dealt with. The problem is kidney stones. I’ve never had them before and now I’ve had two within two years and the last one was really bad. I read this was one of the side effects. I thought I could handle the stones over the migraines but now there will have to be a change.
sd
Wow – me too. I am sexless after years of a phenomenal sex life with my husband. I have been wondering what on earth was wrong with me. I am 49. Thought maybe it was menapause. I have zero sex drive and it is very difficult to orgasm. It is very comforting to read all of these comments since the side effects on Topamax do not say much about decreased sex drive/libido as an adverse side effect. I am on 115 mg daily and the medication is working for the most part, but I still get migraines every two weeks or so, so am not in a position to go off it, yet I definitiely need a solution to this problem.
I plan to speak with my doctor —
Shelly
At 46 I began the generic Topiramate for migraines. I was started with 25mg. I had mind fog and finger tingles but kept on taking it. At 37.5 mg they became worse and I noticed some sexual things happening but I figured it was part of menopause. When I got to 50mg I became totally asexual. Saying “Decreased libido” is such an understatement it’s a joke.
I had vaginal dryness to the extent that even using moisturizers wasn’t helping. And my entire vulval area was totally dead, it was beyond numb, what I imagine being paralyzed must feel like. Even with enough stimulation to get aroused I couldn’t achieve an orgasm. It was awful.
My PA was suggesting it was menopausal and wanted me to start transvaginal hormone therapy but I decided that I didn’t need the Topiramate as much as I did the affection of my very patient husband.
Oh, and the topiramate never did anything for my migraines. I’ve successfully used Maxalt MLT sublingually for years.
jg
I had been on Topiramate 300 mg from March of last year, for migraines and a disorder. It’s the only medicine I can take, I too lost the ability to climax, I couldn’t even feel sex:( I slowly weaned off the drug, orgasm and sexual feelings came back after about a month, but now I have massive migraines again and my disorder is through the roof.
So I”m not sure what to do. I can’t take any of the other meds for either of my issues. I am happily married. I did lose weight as well, which is nice because I have issues with weight but when I went off of Topiramate (topomax) ALL the weight I’d lost 37 lbs on it came back in a month:( UGH!!!!! So now to decide, what is more worth it:(??????????
KK
7 months ago I begin taking Topomax and I thought it was the wonder drug! I lost weight (always a plus in my book), and it helped with my horrible migraines!!! However, I it has caused the worst side effect I could think of; I have lost the ability to climax! It was not until tonight reading this website that I come to realize that I am not alone. Because, I was really starting to think something was wrong with me and my husband. Now that I understand this is a side effect I am going to talk to my doctor about reducing my dose from 100mg to 75mg and see if it works.
Thanks
DW
I’ve been on Topamax for years for bi-polar disorder. It has worked great. Then 11 months ago I lost the ability to have an orgasm. My Doctor was stumped as what it was, the traditional information on Topamax mention nothing on inability to achieve orgasm. My Doctor is first reducing the dose to see if that helps, if not he’s taking me off of it.
JA
Unfortunately, I have experienced this. I am on 75 mg for migraines and am supposed to go up to 100mg tonight. I’ve never had problems with sex drive or orgasms. I still have a strong sex drive but cannot achieve orgasm at all since increasing the dosage from 50mg to 75mg. I’m going to talk to my doctor about it because this is not an acceptable side effect, but since I still have migraines daily, I’m not in a position to stop taking it without an alternative either. :(
MG
I have had the same result as you. My orgasms are now over the top and now I can have multiple. It has definitely helped me lose weight. I wonder why our experience is so different from others.
EM
I must comment that I have experienced the complete opposite with Topamax and orgasms. I have been taking Topamax 75mg at bedtime for 2 yrs now for migraines. I was having to take Imitrex 100 mg up to 3 times a day at times for horrible migraines. While titrating up to 75mg of Topamax, I did have that foggy feeling for about a week until thinking clearly again. Shortly afterward, I was very surprised to notice that my headaches decreased significantly. Now, I only get them around my period…right after starting. More surprisingly, my experience with orgasms has been nothing short of phenomenal. I am now 43 and have had a somewhat satisfying sex life with my husband of 12 years, but, I have been pleasantly puzzled by the amazing neurological “high” that seems to come along with orgasms now. It has to be the Topamax! Additionally, it significantly curbs my appetite, enough where I truly forget to eat. In short, I am very pleased with Topamax…much less number of headaches, incredible orgasms, and less appetite…what more could a forty-something happily married mom need?!
AG
I take 25mg twice a day and have for a year and a half. I’ve not experienced any lack of desire or trouble achieving orgasm. In fact, I would say our sex life is better since I’m not spending 4 or 5 days per month experiencing or recovering from a migraine. Topomax has been a wonder drug for me. I’ve had 2 migraines in the past year and both were extremely mild compared to previous episodes.
Beth
I took Topamax when it was suggested for another malady. Not only did it have no beneficial effects for me, it also caused cognitive impairment, far beyond the language impairment my doctor was aware might occur. After several years away from the drug, I am still impaired.
Nancy
I’m 52 years old and have been taking topamax for almost 2 1/2 years. My sex life was slim but since seeing your article are realized that since taking topamax I have no desire to have intimate relations with my husband. This is driving HIM crazy. After reading this, I’m considering cutting back on my topomax. I take 100 mg at night and 25 mg 3x a day to keep my migraine away. This has worked. Nothing else would. I have only had 1 migraine in a year. First thing that has worked in my entire life. Some choice to make.