In light of 2025 ACP guidelines on episodic migraine prevention placing topiramate as a 3rd line agent due to discontinuation from adverse events
                    
	
	
		        	
	
	
 New comment by  at Ascension Health ( June 25, 2025)
I had a patient who had a severe acute narrow-angle glaucoma within 48 hrs of the start of Topamax at 25 mg to the degree requiring surgical intervention by an ophthalmologist...