"i&#039;ve been on 50 mg of brand topamax for two years and the cognitive impairment is significant. i often forget how to spell my last name, i don&#039;t remember events of just yesterday, and i can&#039;t spell anything anymore for the life of me. i take it for rapid cycling bipolar i &amp; went off it for two weeks to attempt to get my cognition back - by about the 6th day i started to show signs of mania and by day 8 i was full blown manic with psychosis. i&#039;d do anything to get off this brain mush of a drug but it serves a purpose. oddly, i never went into psychosis until this drug. oh, and the days that passed without topamax lead to the worst headaches ever. buyer beware."