Is it safe to take topamax (topiramate) with other pain medications?

Maybe. Topamax (topiramate) can be used in combination therapy with other pain medications. Treatment should be done by a qualified pain management specialist familiar with chronic medication management with topamax (topiramate) and other pain medications. Topamax (topiramate) can have the desirable side-effect of significant weight loss.
Not recommended. The combination of topamax (topiramate) and opiates increases the risk of CNS depression and cognative impairment.