I am sorry you feel so unwell. It is good that you have the nausea under control. I am no expert by any means. I took the med topamax myself for just over 3 years. I am just beginning to taper off of it to start a different med. I was told by my doctors that it would take about 3 months to really feel the full benefits of it. It was very frustrating for me because I was in a lot of pain and the doctors would just tell me I had to wait a bit longer for it to work. 50 mg may be the right dose for you, only you and your doctor can make that call. Throughout your treatment on topomax you may end up experimenting on different dosage levels to find the right amount for you. It is a tricky balancing act of benefits versus side effects. Don't worry it is not that bad, your doctors are awesome and keep a great eye on you!
Good luck on your journey. Good health to you.