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Dr. Bob is Robert Hsiung, MD,
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Posted by platinumbride on October 23, 2003, at 14:26:15
In reply to Re: what dose were you at that you lost 20 lbs.?, posted by headachequeen on October 23, 2003, at 13:59:43
> >i have heard it said that topamax can have antidepressant properties as well...
Sounds as if you have found your miracle drig ;)Keep drinking water though....
Dianewow everyone.....
> >
> > i think i am one of the few who can still eat!!!
> > i'm now on thyroid hormone too. maybe this will help the metabolism, but i am amazed at my appetite which is one of the few things which never fails me!
> >
> > Diane
>
> I thought that my appetite fit into that category for a long time... and questioned my will power too... for a while I linked my weight to depression... then a breakdown meant a visit to hospital where I discovered, that the cause of the visit aside, which was severe stress for lack of a better term, playing upon events in my past, I was not depressed and didn't fit into the area where a psychiatrist could help me...
> I had been taking anti-depressants which had been increased while I was in hospital, along with the Tegretol... I was sent home after about a month with the advice to continue taking the increased doses of anti-depressants, and to seek the help of a psychologist... I had a personality disorder but was not depressed... the disorder caused by childhood and teenage events... so off to the psychologist and psychotherapy. I found a really good one, to whom I can relate very well... the pills continued... Zyprexa was one of them,Immovane another and I forget the other,although I had been taking Welbutrin until I started taking Tegretol... one day something he said made me think that the pills were suppressing my emotions.. how could I get help if I could not reach out for it... and with suppressed emotions and repressed memories that meant I could not reach out... so I quit taking the anti-depressants... this happened in January of this year, about the time I started taking Topomax ...
> no one told me that I should not stop 'cold turkey'... I had no problem stopping and was beginning to achieve something as far as the psycotherapy was concerned... March is always a bad time for me, so in February my doctor increased my dosage of Zyprexa and the other anti-depressant... I didn't like to tell him I had quit taking them entirely, afraid he might be angry and dump me as a patient...
> when I did tell him in March - said I had been off the stuff for a month :( - he was suprised, said the idea had been to wean me off it slowly and asked if I wanted him to prescribe something to help me adjust to life without the meds... and wanted to know if I had simply gone cold turkey... well, yeah????
> then said that if that was required patients were usually put in hospital for a while and other meds substituted and ... I was almost as shocked as he was...
> I am wondering now if some of the weight problem was related to the use of the anti-depressants ...
> I was using them for much longer than I have been on Tegretol and much much longer than I have been using Topomax...
> but have to admit that the weight loss of note has been in recent weeks...
> while I began to lose two or three pounds a week at the beginning of using it, the weight loss began to be really noticeable when I reached 300 mg a day...
> and now, at 400 mg a day, as I said I have lost almost 45 pounds...
>
> I have read the other posts regarding side effects...
> while I had been warned about the effects of alcohol I had not been aware of the risks of kidney stones for instance, but I do find that I am always thirsty... and in the early weeks of using the med, I found dry mouth a constance annoyance...
>
> while the neurologist warned me that there might be a problem with confused speech, I have not had a problem in that respect either...
>
> so I seem to have gotten off lightly...
>
> I am surprised to read of the broad spectrum use Topomax has... here I thought it simply dealt with seizures and migraines and considered it a miracle drug in that I had not had a migraine since starting to use it... and that is a miracle in itself...
> the weight loss is the icing on the cake...
> but I keep wondering when it stops????????
>
Posted by Nissy on October 23, 2003, at 17:32:25
In reply to Re: what dose were you at that you lost 20 lbs.?, posted by headachequeen on October 23, 2003, at 13:59:43
I had been warned about the effects of alcohol & I do find that I am always thirsty... >
**************************************************
What kind of effects does alcohol do?? I had a glass of wine at a get together and I felt just horrible. I also get thirsty. I feel so dried up all the time.
Thanks,
Nissy
Posted by headachequeen on October 23, 2003, at 21:13:20
In reply to Re: what dose were you at that you lost 20 lbs.? » headachequeen, posted by platinumbride on October 23, 2003, at 14:26:15
> >i have heard it said that topamax can have antidepressant properties as well...
Sounds as if you have found your miracle drig ;)Keep drinking water though....
DianeOkay, next question... why the water? and why are we not given more info when we start taking these meds? Is it too much trouble for the pharmacist to earn that dispensing fee ????
Posted by headachequeen on October 23, 2003, at 21:26:35
In reply to Re: Topamax Weight Loss Advice?-UPDATE » Bear, posted by platinumbride on October 14, 2003, at 23:43:34
> I have been told, a beautiful woman......"what >a shame she doesn't lose some of that >weight....she has such a beautiful face"
I know that this board is not really about weight and weight loss or retention... but as I read the previous posts to learn more about Topomax and its (potential??) side effects, this post jumped out and hit me...
Diane, sometimes , especially in a woman, weight gain or overweight, or call it what you will, is a statement that she doesn't care what the world's pattern for her may be.. she knows who she is and what she can do, and does not want to fit into the hole on the game board that others expect her to fill... sometimes she is trying to make people meet her on her own terms... to make them accept her as being intelligent and capable and not a Barbie doll type...
I am not trying to play shrink here, but I know as I look back that my bout with anorexia was a scream for someone to notice and help me as I tried to deal with the things that were happening in my life, just as the extra weight later was a way of telling the world that if noone wanted to help me then, I didn't want to play by its rules now... I was smarter than most of them anyway so what did looks matter anyway?
I don't pretend that I would not have liked to be slimmer but not to please anyone out there...
of course there are few if any photos of me taken during that time...
Topomax was not intended to be the cure for not liking myself... it was to help with epilepsy and migraines... and it is doing that... but along the way it has changed the weight pattern... and I like that too... since January I have changed from size 16 jeans to size 10 jeans and can wear size small jeans and from XL sweaters to medium... and I feel quite smug about it...
the shrink bit helps too as I am beginning to feel better about being me... and all that goes with that... but who cares what the people who see you and think that you might look prettier thinner???
How do you look at you??? Put on make-up, dress so that you feel good about you, and go out there and look them all in the eye and dare them to think otherwise... don't let them get you down...
or put you down...
they may be thin... but they aren't perfect...
kat
Posted by California_Princess on October 24, 2003, at 18:07:41
In reply to Re: Topamax Weight Loss Advice?-UPDATE, posted by headachequeen on October 23, 2003, at 21:26:35
I'm glad that everyone has been able to lose weight with the Topamax. I was sooo depressed when I had to stop taking it. If the side affects weren't so severe I would have continued to take it. Even the mental fog, which would have kept me from working, driving out of town and pretty much anything that has anything to do with thinking... I would have kept taking it.
I'm 140 pounds over weight and am desperate to lose. My pdoc put me on Lamictal now and I’m still so depressed about having to go off of Topamax. While the Lamictal doesn’t make you gain weight, it doesn’t help you lose it, either, (my appetite is still there!).
Has anyone heard of Zonegran? It’s supposed to be like Topamax, but better as it doesn’t have the severe side affects that Topamax does. I asked my pdoc about it, hopeful that he would put me on that drug, but he hadn’t even heard of it and just gave me the dumb Lamictal.
This Zonegran is supposed to be even better than the Topa at weight loss and it even lists anorexia as the number two side affect. Other than that it just lists a little dizziness and nausea.
I sure wish I could find a drug that my regular MD could give me that would take away my appetite as well as Topamax did.
My obesity is as big an issue as my Bi-Polar. Especially since both my parents are diabetics and my grandfather died of heart disease. I do not feel normal or healthy at 275 pounds but can’t seem to get this off. It takes a HUGE amount of effort to lose, but I can gain 10 pounds in one day!
Melissa in CA
Posted by Sooshi on October 25, 2003, at 7:54:32
In reply to Topamax Side Affects!, posted by California_Princess on October 24, 2003, at 18:07:41
Hi Melissa,
I don't have much advice here, since I haven't started Topamax yet (start tomorrow) and haven't used Zonegran, but I had a long talk with my pdoc about both. He wanted to start me with T because of its better mood stabilizing history (I have BP) and if I couldn't handle the SE's, he will switch me to Z. I have heard that Z has some nasty SE's too, but possibly not as bad. I would give Zonegran a try, especially since your issue with weight is very important to you...believe me, I understand!Good luck to you!
Posted by California_Princess on October 25, 2003, at 21:34:36
In reply to Re: Topamax Side Affects!, posted by Sooshi on October 25, 2003, at 7:54:32
Thanks Shooshi! :O0
I think I will ask my pdoc about it agin when I see him next month. This time I will probably bring some information with me.
Melissa
Posted by Katt on October 25, 2003, at 22:56:37
In reply to Topamax Side Affects!, posted by California_Princess on October 24, 2003, at 18:07:41
What side effects are you guys having?
I got into an arguement about the year we are in with someone the other day -- I kept saying it was 2002 - they kept telling me it was 2003. Sure enough! It was 2003!!! Ahhhhh!!!! how embarrassing!! i think. actually, i didn't even care. i went home and took a nap. but i have lots of sores in my mouth -- you too?? when i brush my teeth, my gums bleed everywhere. sleepy sleepy sleepy.
I am pretty thin, about 20 lbs underweight, but have no desire to eat, but that is great to me!!
what side effects are you all having?
Posted by chicago77 on October 25, 2003, at 23:16:07
In reply to Re: Tomamax for weight loss, posted by Wrain on September 8, 2003, at 8:51:22
I am also very curious about the dosage for Topamax for weight loss. I currently take Wellbutrin for depression and have no side effects that I am aware of. AND, if you didn't know, they came out with once-a-day dosing... Wellbutrin XL (which is great for me b/c I kept forgetting to take the evening dose, or I'd be somewhere w/out my meds).
Anyway, I also have migraines, although I haven't had a full-blown attack in about a month. However, I am a grad student and was talking to a lecturer that spoke on migraines. I asked her if the prodrome/aura symptoms (visual disturbences in particular) are indicative of a neurological disorder, just as if I was experiencing full-out attacks. Her belief is that migraines are just as much of a neurological disorder as epilepsy (and she works at Diamond Headache Clinic- very famous). So, it would make sense that migraines at treated in a similar way.
As far as the Wellbutrin/Topamax combo, since Wellbutrin typically lowers seizure threshold (making it more likely that you MIGHT have a seizure), I would think that adding on an anti-seizure med (which Topamax is) would be a good idea!
So, back to my original questions... what is the typical dosage of Topamax for weight loss, because I've seen posts that range from 50 mg once a day to 200 mg twice a day! Has anyone noticed drowsiness to be a side effect of Topamax? If so, has taking the med at bedtime made any difference, or does the drowsiness seem to persist thoughout the day? (Geez- can you tell I'm studying for a medical profession?!) I have an appointment with my psychiatrist this coming Thursday (it's Saturday night), and would really appreciate any advice before then so I seem well informed. I will let everyone know how it goes and, if I get a Rx, will update my progress. Thanks everyone!!
Posted by Katt on October 25, 2003, at 23:25:32
In reply to Wellbutrin update question on Topamax dosage, posted by chicago77 on October 25, 2003, at 23:16:07
Right now I am taking 25 mg 4 times a day (100 mg) and 1200 mg of Neurontin, going down (I was on 3200 mg. Taking this all for pain, refused to do this for psych reasons, but now I have no choice. Before, I was just trying to kill myself all the time. Now, I just can't move or get up without assistance. So the pdocs are laughing.
Posted by chicago77 on October 25, 2003, at 23:43:46
In reply to Re: Wellbutrin update question on Topamax dosage, posted by Katt on October 25, 2003, at 23:25:32
just out of curiousity... what is a pdoc?!
Posted by platinumbride on October 26, 2003, at 7:23:41
In reply to topamax..sigh :( » phillybob, posted by platinumbride on October 18, 2003, at 15:25:30
I wish I could find the very kind post that someone sent in regard to something I had said so that I could say thank you. It was in response to someting I had written about such a pretty face, what a shame she doesn't lose some weight.
If the sender is reading this, thank you. It was very kind of you to take that time out.
I wish I could read it again.
If you care to send it again, pls do so at dielotosblume1@yahoo.comty
Diane
Posted by headachequeen on October 26, 2003, at 11:11:58
In reply to Wellbutrin update question on Topamax dosage, posted by chicago77 on October 25, 2003, at 23:16:07
I wish I could state a definite dosage for weight loss <g>
I was originally seeing my neurologist for epilepsy -- had never considered migraine as a neurological problem -- duh -- and I am supposed to be a highly intelligent individual ....
until I saw the posters in his office...at one point when my doctor thought I was suffering from depression I was on Wellbutrin and Zyprexa and Imovane; the Wellbutrin was stopped when the epilepsy was diagnosed as it does not work well with most epilepsy meds I was told... no one told me it lowered the seizure threshold... at one time I was enduring twelve and more seizures in a two-month period of time... as my seizures are not the movie style I was not really aware of them and thought that they were related to the depression...
I was exhausted for a day or three following a seizure and sometimes would lose track of the days, would relive the same day over and over until someone pointed out that today was not Tuesday, it was Sunday... when I mentioned this to my doctor, he told me this behaviour was more seizure-related and ordered an eeg and other tests and epilepsy was diagnosed and Wellbutrin with its happy face trademark left my life (I always thought that was rather an overdone trademark to be honest)...
I forget the one that replaced it...
Tegretol was introduced by the neurologist in slow increments
A few months after that, my neurologist always sees patients in three month follow-ups, I asked about migraine and was asked why I had never asked about it before... well it hadn't occurred... this is when the Topomax was prescribed... with the warning that it often causes weight loss... well I decided I could live with that...
within a days of starting to take it.. 25 mg once a day in the evening, I had lost a couple of pounds and that was really exciting for me... I needed that boost for my morale at that particular time...
A month later as I had been told that I was not depressed by the psychiatrists who had examined me after my breakdown but needed a psychologist, I stopped taking the anti-depressants entirely and felt great.
Since taking the Topomax I have not had a migraine... almost eleven months now...
and now that I am up to 400 mg a day of it and have been increased to 400 mg of the Tegretol have had only one seizure since August...
and to me that is really great...
life is beginning to be normal.. or what I consider to be normal...
not only that, but I have dropped enough weight that I can wear a size 10 jean and look like it is meant to be not as if I am trying to squeeze into a sausage casing...
I no longer feel as if people look at my husband with sympathy... and I no longer feel uncomfortable going places...
this has to be contributing to my emotional or mental well-being too...
who knows? I may no longer need the shrink... he may be out of a job one of these days...
well, once we lay to rest the childhood traumas...
and that it seems takes longer than I planned...
but Topomax does not seem to have any massive side effects for me...the dry mouth someone had mentioned could be associated with it or with the meds that go with other problems I am dealing with... oh for the days when I was young and healthy... I guess it is pay back time...
and I drink gallons of water all the time now... since reading the advice here and the bit about kidney stones possibility...
and I do get drowsy at times...but other than that I think it is doing all right for me...
and not having migraines or seizures... well that is all right too
kat> I am also very curious about the dosage for Topamax for weight loss. I currently take Wellbutrin for depression and have no side effects that I am aware of. AND, if you didn't know, they came out with once-a-day dosing... Wellbutrin XL (which is great for me b/c I kept forgetting to take the evening dose, or I'd be somewhere w/out my meds).
> Anyway, I also have migraines, although I haven't had a full-blown attack in about a month. However, I am a grad student and was talking to a lecturer that spoke on migraines. I asked her if the prodrome/aura symptoms (visual disturbences in particular) are indicative of a neurological disorder, just as if I was experiencing full-out attacks. Her belief is that migraines are just as much of a neurological disorder as epilepsy (and she works at Diamond Headache Clinic- very famous). So, it would make sense that migraines at treated in a similar way.
> As far as the Wellbutrin/Topamax combo, since Wellbutrin typically lowers seizure threshold (making it more likely that you MIGHT have a seizure), I would think that adding on an anti-seizure med (which Topamax is) would be a good idea!
> So, back to my original questions... what is the typical dosage of Topamax for weight loss, because I've seen posts that range from 50 mg once a day to 200 mg twice a day! Has anyone noticed drowsiness to be a side effect of Topamax? If so, has taking the med at bedtime made any difference, or does the drowsiness seem to persist thoughout the day? (Geez- can you tell I'm studying for a medical profession?!) I have an appointment with my psychiatrist this coming Thursday (it's Saturday night), and would really appreciate any advice before then so I seem well informed. I will let everyone know how it goes and, if I get a Rx, will update my progress. Thanks everyone!!
Posted by chicago77 on October 26, 2003, at 12:01:16
In reply to Re: Don't Cut Your Pills in half children...... » Larry Hoover, posted by SLS on October 10, 2003, at 19:56:22
I don't know if this issue has been resolved yet, but I used to work in pharmacy and know why they say not to cut tablets in half. If a tablet is scored (that is, it has an indentation/line across on side), the med is perfectly safe to "break" in half (I say break b/c you should be able to hold the tablet and break it with your hands). The reason you should not CUT a tablet that is not scored is because the active medication may not be distributed evenly throughout the pill. Scored tabs are manufactured that way... so if you have a 50 mg tab and break it in half, you should have 25 and 25 in each half. If the tab is not scored, you may end up with 20/30, or 10/40, or who knows what. It's really a matter of consistency in your dosing regimen. You shouldn't be bouncing around on your dosage.
Capsules are similar in that it would be nearly impossible to measure out half, but that's not the biggest concern. The powder, liquid, "sprinkles", etc are placed in that nifty little gelatin casing because you are not meant to take the medication "straight" like that. The capsules (as well as other coatings on tablets, syrups, etc) are meant to get the medication to where it needs to be in order to be metabolized properly. So, that's what I know about cutting pills in half. It's not a ploy by the drug companies to make you have to spend more money or anything like that (the drug companies have plenty of other scams). It's a matter of drug safety and efficacy.
I would also like to add that CR, SR, XR, XL, etc. (any medication the has an controlled release) should NEVER be cut in half! This especially goes to anyone who is switching from WB SR to XL. I went from 150 SR bid to 300 XL and was amazed to see that the tablets are actually smaller than the 150s. Then I realized that the active medication is inside this neat little case and will be released over about 20 hours. That's why they mention (and most people don't actually know this for whatever reason) that you should not be worried or alarmed if you see what looks like the tablet you took (but is actually only the coating/casing)... in your stool! I've never personally seen it, but I haven't really looked!! Point being, controlled release tablets and capsules (even if they are not coated- one just popped into my mind) and NOT meant to be cut. If you need a lower dosage, find a lower dosage. If that is not possible, talk to your health care provider or your pharmacist (they can be very helpful and tend to know more about the meds) to see what you're other options are. Hope this has been helpful!
Posted by California_Princess on October 26, 2003, at 12:11:58
In reply to Cutting Your Pills in Half- esp. extended release, posted by chicago77 on October 26, 2003, at 12:01:16
Thank you so much for all the info!! I always cut my pills in half when starting a new medication because I am very sensitive to drugs and want to know how it will affect me with a low dose first.... fortunately all my pills lately have been scored, like you mentioned. :O)
Thanks again!
Melissa
Posted by Katt on October 26, 2003, at 12:49:22
In reply to pdoc? » Katt, posted by chicago77 on October 25, 2003, at 23:43:46
> just out of curiousity... what is a pdoc?!
sorry...short for psychiatrist.
Posted by Nissy on October 26, 2003, at 22:44:10
In reply to Cutting Your Pills in Half- esp. extended release, posted by chicago77 on October 26, 2003, at 12:01:16
you should not be worried or alarmed if you see what looks like the tablet you took (but is actually only the coating/casing)... in your stool!
**********************
What about seeing the little white balls that are inside the capsule in your stool? I am on effexor XR and I see those white balls all the time. Does this mean my body isn't metabolizing them or absorbing the medication? Do you know anything about this?
Thanks,
Nissy
Posted by chicago77 on October 27, 2003, at 9:01:38
In reply to Re: Cutting Your Pills in Half- esp. extended release » chicago77, posted by Nissy on October 26, 2003, at 22:44:10
> What about seeing the little white balls that are inside the capsule in your stool? I am on effexor XR and I see those white balls all the time. Does this mean my body isn't metabolizing them or absorbing the medication? Do you know anything about this?
Nissy,
I fact I do know about this. This is what I believe is called "sprinkles." There are quite a few meds that are capsules with "balls" inside. You will notice that these are all extended release formulations. This works the same way in that your body first processes the cap to release the sprinkles, then the "balls" are metabolized similarly to a controlled release tab. So, yes, you're body is using the drug and, no, it's no reason for concern. Talk to your doc if it really bothers/worries you.
I do believe that this is one of the exceptions about breaking open capsules. The gelatin capsule dissolves pretty rapidly and the sprinkles are released and go to work. On the other hand, capsules with powder are meant to be taken whole b/c the powder would start to absorb in your mouth, esophagus, etc... before it gets to your stomach. You may want to double check this with a pharmacist. From what I remember, "sprinkle" caps can be opened and (go figure) "sprinkled" over food or mixed in with something like apple sauce for those that may not be able to take it whole (esp. children and the elderly). Hope this was helpful, but remember that I am not an expert on this just b/c I have some experience with it. Be sure to follow your health care provider's instructions and any information provided with your Rx. And ASK as many questions as you want!! This is your health!!
Side note: I am working on my Master's degree to become a Physician Assistant. This is why you will often see me refer to a "health care provider" rather than your "doc." Keep in mind too that PAs are specifically trained to provide patient information and education, and we tend to spend quite a bit more time with patients until all questions are resolved. If there is a PA in the office/clinic that you go to, don't be afraid to talk to them seperately if you feel that your doc isn't "getting the job done." I give a 99% guarantee that you will be very happy with their service and caring!!
Posted by Nissy on October 27, 2003, at 13:12:16
In reply to Re: Cutting Your Pills in Half- esp. extended release » Nissy, posted by chicago77 on October 27, 2003, at 9:01:38
Thanks for all the information. You will be a wonderful PA someday!!
Good Luck,
Nissy
Posted by DarcyP on November 1, 2003, at 3:50:41
I have lost about 75 Pounds over the last year taking Topamax,but now I am faced with severe abdominal pain,I have been tested for everything,from Urinary Tract Infections,Kidney Stones to STD'S everything comes back clean(Thank-God)but my Doctor is totally baffled as to whats causing my pain,I see that one of the side effects is severe abdominal pain does anyone know if a person could start getting this after a year of taking it with no problems?Oh and the pain started on the right side and has spread to the left and doesnt leave even with painkillers it's a constant pain...Thanks for your help
Posted by DharmaMama on November 1, 2003, at 21:08:37
In reply to Topamax and Severe Abdomin Pain, posted by DarcyP on November 1, 2003, at 3:50:41
I take it you are female.
Posted by DarcyP on November 2, 2003, at 2:28:40
In reply to Re: Topamax and Severe Abdomin Pain, posted by DharmaMama on November 1, 2003, at 21:08:37
No Male...:)
Posted by karen_kay on November 2, 2003, at 17:21:07
In reply to Topamax and Severe Abdomin Pain, posted by DarcyP on November 1, 2003, at 3:46:00
Hmmm..... I have no idea. I hope that doesn't happen to me. I would check with the doctor first of course and get some advice. Karen
Posted by DharmaMama on November 2, 2003, at 21:52:53
In reply to Topamax and Severe Abdomin Pain, posted by DarcyP on November 1, 2003, at 3:46:00
Have you checked with a ob/gyn or midwife?
Posted by DharmaMama on November 2, 2003, at 21:58:17
In reply to Re: Topamax and Severe Abdomin Pain, posted by DarcyP on November 2, 2003, at 2:28:40
Sorry, saw this posted twice. Answered to it at another post. My other post would not apply.
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