I have simple-partial seizures and take Lamictal and Keppra. My seizures are only partially controlled with medication, but the incidence of seizures is much lower on medication than off. Lamictal is a drug that is typically started at non-therapeutic levels and then scaled up. This is due to a severe potential side-effect which I fortunately did not have. For me, once I reached the therapeutic dose level for Lamictal, I did notice a significant decrease in seizures, but it turned out to be a honeymoon effect (it lasted for a limited period of time). I've noticed an increase in memory problems since going on Lamictal, though it's difficult to conclusively identify Lamictal as the cause (since Lamictal initially reduced seizures, my memory may have temporarily improved, followed by a reduction in Lamictal's effectiveness, which might have led to an increase in memory problems, etc.). I am going to talk to my doctor about going off Lamictal completely to see if the extent of seizure-control that I have right now is coming from Keppra alone.

By the way, about Keppra -- it is definitely working for me, albeit not perfectly. My doctor had me go off Keppra (in a controlled environment) and there was a significant increase in seizures. I don't think I have the psychological problems that I've heard some people on Keppra complain about -- increased irritability, anger issues, etc. -- but that's just my own opinion!

Ask your doctor about Nuvigil. It is tradionally used for shift worker adjustment or for those with narcholepsy. I am also on Lamictal. In the morning I take a very small dose of Nuvigil- the smallest tablet is 50mg and I take half of that. It helps me with staying awake during the day. Thereby I sleep better at night.

I have been on topamax for around a year and a half and I love it! I was on Keppra and Lyrica before topamax and they worked, but not as well as topamax has workd for me. However, I have heard the Keppra is good for people with Grand Mal seizures, which I do not have.

I do not have any of the side effects you listed besides weight loss, but I was overweight to begin with. I stopped losing weight at a weight considered normal for my height (my BMI now 22%) and I can eat pretty much whatever I want without gaining anything.I consider this to be a positive, actually. I am not tired, or at least any more tired than I ever was before. I feel more awake than I was on Lyrica or Keppra.  I can tell you my memory is not as sharp as it was before I started having episodes, but it is not significantly different and I cannot blame it on the topamax. I was in college still when starting topamax and ended both semesters on the Dean's List, so I feel like for me it did not have side effects listed. I am now down to only 1 episode a month maximum. I sometimes go a month without an episode.

HOWEVER:

There was one time that I did have side effects. This was when the doctor raised my dose TOO FAST. Then I was tired, very tired. Since I had been on the medication successfully before I called and told him I was having problems and he said the dose was being raised too quickly and to slow down. It look me maybe 3-4 months to get to the correct dose. If you are on it and start to notice you feel weird then call your doctor. I went to the neuro every few weeks while starting it. Also, note that it can cause kidney problems if you take it for too long. Because of this I take potassium EVERY DAY and try to drink at LEAST 8 glasses of water a day. 

On a side note, I recommend caffeine if you have migraines, which you have probably heard before, but it is very true. I consider my 2 shots of espresso a day to be migraine preventative.