If I recall correctly I was taking 175 mg for headaches, and it wasn't helping at all. I started at 25 mg, and worked up to the dose I was taking, maybe even 200, I can't remeber now. I changed neuro's and after evaluating me, he decided the Topamax was not helping me at all, am I was weaned off it. No change without it, no bad symptoms on it or off it...although, I have symptoms and many other ailments, so who knows which symptom belonged to which issue! I never lost weight on it either.