I mentioned this before, but perhaps you missed it?

Why are you taking Toprol? Toprol's most common side effect is cold
extremities.

In regards to your other incident, I personally think it was the Topamax.
This drug is nicknamed Dope-amax because of its serious side effects for some people. It is very confusing and sedating for some.

The clonidine patch takes a few days to work up to thereapeutic levels.
I don't think you would have had extreme side effects from it in one day.

Many people with cold hands/feet do very well on magnesium--which dilates
blood vessels. YOu can try soaking in lukewarm water with epsom salts to see
if it improves things. Epsom salts have magnesium in solution, which can get
to the fingers and toes easily. This is simple and inexpensive.

Good luck.