My Topamax dosage was raised by 50mg to 375mg a day, in addition to the lamotrigine (250mg), protriptyline (50mg) and methylphenidate (a whopping 5mg). This has allowed me to take the methylphenidate daily, work on a crossword puzzle if I don't have anything better to do, and eat food seasoned with nutmeg and cloves without worrying about having an aura. Taking the methylphenidate is especially important because taking it daily means my sense of smell and memory are better, and the tremors aren't as bad.
One downside is my appetite isn't worth shit. More Topamax + daily methylphenidate = can't even force myself to eat that much. I'm not dangerously skinny, gaining weight is just another thing I've given in to giving up on. While nutmeg and cloves are kosher again, peanuts are now part of my permanent Lent. No peanuts means no peanut butter. No peanut butter means no peanut butter and banana milkshakes, which were a great means of caloric intake when I couldn't deal with cooking and/or eating. Fortunately I don't have the "look at a peanut and die" allergy, just an "eat peanut butter and spench" allergy or sensitivity of some kind. As peanuts are legumes it doesn't surprise me that they'd eventually not like me any more. The cost is too prohibitive for other nut butters.
I've gone back to needing nine to ten hours of sleep. That wouldn't bother me if I were able to go to sleep at nine PM. I'm lucky to fall asleep at 10:30. Waking up after eight in the morning just messes with me.
The oddest effect is a kind of jamais vu or other Topamax-related size issue. When I'm doing a crossword puzzle it won't matter how many times I count the number of squares and the number of letters in the word or phrase I know is the answer, I can't make it fit. It's too short, it's too long, I've yet to discern a pattern.