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The new Topiramate tablets have a new appearance, but they have the same active ingredient. The metabolic breakdown of Topamax will be reduced increasing the duration and intensity of its effects. The prophylaxis of migraine headaches. It is important to take Topamax regularly to get the most benefit. It is important to take Topamax regularly to get the most benefit. Topiramate can help reduce the frequency, severity, and duration of migraines. Pay special attention to how you are responding while on this medicine.