Topamax has been approved in prevention of migraine headache. Topamax works well though it is not a primary prevention medicine. Primary prevention medicines in migraine headache that are the gold standards are beta blockers such as Inderal, Metoprolol, and Tri-Cyclec antidepressants such as nortriptyline. Dosages used for prevention in migraine are different then when the medications are used for different conditions. Topamax is very effective but people may experience cognitive problems such as confusion and inability to think correctly. This generally subsides with time and generally is not a problem when appropriate doses are used. The dosing of Topamax should be done very gingerly starting at a low dose level and escalating very slowly. Other medications in this category such as Depakote has proven effective in clinical trials. Complications of Depakote can include weight gain, lethargy, and hair loss. In the new formulation this has been largely avoided. Keppra, an anticonvulsant that has been used in the treatment of migraine headache and this might be a consideration. It has not been as rigorously studied as Depakote and Topamax.