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Temperature plays a role too

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Side Effects and Risks of Topamax Common Side Effects Decreased appetite and weight loss Dizziness Unusual sensations (numbness, tingling, burning) Decreased sensations in the skin Memory or speech issues Stomach pain, nausea, diarrhea Dysmenorrhea (pain with menstrual periods) Cold and flu-like symptoms Serious Risks and Warnings Seek immediate medical attention if you experience any of the following: Suicidal behavior or thinking Increased heart rate (palpitations or racing heart) Vision issues Mood changes and cognitive changes Cognitive impairment (difficulties with concentration, attention, memory, speech)

(J Physiol Paris, 2001

After each concentration increase, allow four to six weeks for your skin to adjust before assessing results

n = 3 technically independent samples