My doctor started me on topamax for chronic pain. I started on 25mg and have increased by 25mg a week. I am now at 100mg. I just put this together - I'm slow - but, I have so much fatigue anyway it's hard to tell what is coming from what. At 50mg, I was sleeping 19-21 hours straight. When I was awake, I was so tired I was miserable and I all I could think about was sleeping. However, as it got closer to the end of the week on that dose, it tapered off. IOW, it seems as though my body is adjusting. However, as the dose increases, I'm sleeping more and more during the initial phase so that now at 100mg I'm awake for a couple of hours at a time, otherwise I'm asleep. I've just started the 100mg dose. The cognitive dulling is also getting worse, but seems to taper off as I adjust to the dose. However, today it's so bad that I couldn't remember my phone number and I'm actually slurring my words. When I'm awake, I'm miserable and feel sick and all I can think about is going back to sleep. All I want to do is close my eyes and sleep and I don't care if or when I wake up. I just want to sleep. I deal with a whole lot of fatigue, but this is a whole other level. I would stop the medication completely, but it seems that I do adjust. My doctor wanted me to go next to 200mg and I called the office today and said there is no way I'm doing a 100mg bump. But, I don't want to do this for 4 more weeks either, doing a 25mg bump every week. I have *a lot* of appointments - important ones - in the next 3 weeks. I'm barely functioning. Any advice?