Adverse effects associated with topiramate therapy include ataxia, impaired concentrations, confusion, dizziness, fatigue, paraesthesia, drowsiness, and difficulties with memory or cognition. Agitation, anxiety, nervousness, emotional lability (with mood disorders), and depression may also occur. Other reported adverse effects include abdominal pain, anorexia, asthenia, diplopia, leucopenia, nausea, nystagmus, insomnia, psychomotor retardation, impaired speech, altered taste, visual disturbances, and weight loss. The risk of developing renal calculi is increased, especially in predisposed patients. Reduced sweating with hyperthermia has occurred particularly in children. Rare cases of myopia with secondary angle-closure glaucoma have been reported.