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I am Mysticdoc, experienced Internal Medicine Specialist.
I am here to help you with your concerns.
Topiramate is a good medication prevent frequent migraines.
Topiramate has mild to moderate side effects.
The side effect are much less below 100 mg daily dosage.
The most common side effect is paresthesia which usually subsides over time.
There is some risk of hair loss as well ( 2%) --but less common in low dosage.
The efficacy of topiramate is equivalent to propranolol.
However, topiramate has unique feature of causing weight loss compared to propranolol.
Hence, if your migraine is not controlled by propranolol, topiramate is a good choice since side effects are less common with lower dosage.
But if you are concerned about hair loss, then your other option will be to use a different medication.
Verapamil is one such medication which has better side effect profile.
Hence, you can discuss this option with your neurologist.
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