Tapering off Topiramate after Paxlovid

Posted by shanrob7 @shanrob7, Feb 17, 2023

Hello,

Scenario: I recently had covid and was prescribed paxlovid. The clinic doctor told me it was contraindicative with the Topiramate I take for migraine prevention and I shouldn’t take it during the 5 day paxlovid treatment. I’ve read that suddenly stopping Topiramate can cause withdrawal, but my prescribing neurologist was already planning on tapering me off of it before I got covid. Unfortunately, my neurologist is no longer practicing and the transition time to get to a new neurologist is a much longer wait than my taper schedule was supposed to be.

Question: Since I’ve already gone 5 days without Topiramate, should I even do the taper off schedule? Or just take the paxlovid period as the cold turkey cut off and not come back onto Topiramate?

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Goaway | @nemo1 | Feb 17, 2023

When meds I’ve taken I stopped abruptly (I don’t recommend it), the symptoms came back with a fury in short order. I suggest you get a medical doctors opinion as how to handle meds and changes. Best of luck to you. Feel better.

PS: I was on topiramate as a migraine preventative and had to come off it to try other migraine meds. I don’t recall step down procedure. Just want to make sure you are safe.

Leonard | @jakedduck1 | Feb 17, 2023

@nemo1
Stopping seizure medications abruptly is VERY DANGEROUS. You could have a seizure even if you don't have a seizure disorder. I’d inform your primary care physician to what you've done and follow their advice. Just because you haven't had a seizure yet doesn't meant you won't. Fingers crossed you won't.
At the very least when you need or want to stop a medication, talk to your pharmacist.
Hope all works out,
Jake

Goaway | @nemo1 | Feb 17, 2023

I’m sorry I did not say what meds I discontinued or rather the “dr” discontinued and he did so abruptly. I had major confusion and other things happen. It was not from seizure meds.

Thank you for your very helpful reply. I did not mean to be careless, but do understand the importance of supervision when stepping down on a med.

I am on a anti seizure med for another condition. Thank you for that info. I will recall it if and when I ever have to change out that med!

Nemo