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Depression and mood problems may occur in epilepsy and migraine populations (5.6) Fetal Toxicity: TOPAMAX use during pregnancy can cause cleft lip and/or palate (5.7) Withdrawal of AEDs: Withdrawal of TOPAMAX should be done gradually (5.8) Hyperammonemia and encephalopathy associated with or without concomitant valproic acid use: Patients with inborn errors of metabolism or reduced mitochondrial activity may have an increased risk of hyperammonemia

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