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However, compliance is imperfect and deadlines apply to plan decisions , not necessarily to patients receiving drugs

Seek medical advice if temperature consistently exceeds 38.5C, sweating severely disrupts sleep, or palpitations accompany flushing

Talk with your doctor before taking Topamax if you have: eye problems, such as glaucoma a job that requires working in hot weather or a hot environment a kidney condition, such as chronic kidney disease a breathing condition, such as chronic obstructive pulmonary disease a ketogenic diet that you follow chronic diarrhea depression or other mental health conditions a history of suicidal thoughts or behaviors osteoporosis or weak bones caused by another condition a liver condition, such as cirrhosis upcoming surgery scheduled a pregnancy a baby you are breastfeeding regular alcohol consumption an allergic reaction to Topamax or any of its ingredients Get in-depth information about Topamax interactions

Some individuals prefer to start treatment within a multidisciplinary programme that includes dietetic and psychological support, which NHS England funding guidance recognises as best practice