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Call a healthcare provider right away if you have any of these symptoms, especially if they are new, worse, or worry you: Thoughts about suicide or dying Attempts to commit suicide New or worse depression New or worse anxiety Panic attacks An extreme increase in activity and talking (mania) Feeling agitated or restless Trouble sleeping (insomnia) New or worse irritability Acting aggressive, being angry or violent Acting on dangerous impulses Other unusual changes in behavior or mood Topiramate may lower bone mineral density

The difference is the approved maximum dose and the indication on the label

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