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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 18 of 18. This is the beginning of the thread.
Posted by KarenB on March 13, 2000, at 22:37:12
I have read that Topomax has been used as a mood stabilizer and is associated with weight LOSS, rather than weight GAIN. Anyone have any experience with this? I am atypical Bipolar II with extreme fatigue symptoms when off meds (or when on the wrong ones).
Thanks!
KarenB
Posted by Cam W. on March 13, 2000, at 23:05:25
In reply to Topomax as mood stabilizer?, posted by KarenB on March 13, 2000, at 22:37:12
Karen - Topamax (topiramate) is an anticonvulsant/mood stabilizer. It is used as add-on therapy in bipolar disorder to augment the standard mood stabilizers. It is being tested to see if it will reverse the weight gain seen with atypical antipsychotics (eg Zyprexa). The dosage of Topamax must be increased slowly. Starting dose is 25mg daily and increase by 25mg (sometimes 50mg) every 3 to 5 days to a dose usually between 200mg and 400mg daily. If the dose is raised quicker, the side effects are worse, especially cognitive (thought) problems. People have complained of trouble in name finding and simple mathematical problems. Drowsiness, dizziness, nervousness and nausea can also be problematic. Overweight people seem to lose more weight than underweight people, but weight loss is not seen in everyone (books say approx. 20% - probably a little higher). Topamax should not be used just for weight loss, as it has profound effects on mood. There is a study being done in Southern Ontario to see if it will control obesity, though. Hope this helps - Cam W.
Posted by Brenda on March 14, 2000, at 10:15:03
In reply to Topomax as mood stabilizer?, posted by KarenB on March 13, 2000, at 22:37:12
> I have read that Topomax has been used as a mood stabilizer and is associated with weight LOSS, rather than weight GAIN. Anyone have any experience with this? I am atypical Bipolar II with extreme fatigue symptoms when off meds (or when on the wrong ones).
>
> Thanks!
>
> KarenBKaren - I was on Topamax 100 mg. for about 3 months as a mood stabilizer. It DEFINITELY caused weight loss. If you have hypoglycemia it's important to make sure you eat. The most annoying symptom I had with this med was ringing in my head and a sensitivity to noise. I was having a Major Depressive episode and the Dr. thought I was BPII. It did help with the depression. However, I noted a lack of creativity or rather a desire for creativity. That feeling, though, could also have been a result of the depression. It's hard to say. I quit taking the Topamax and stabilized on Zoloft alone. My creativity is back - and the suns out again, too. It's probably all tied together. I have a cousin who is BPI and on Topamax and Depakote and she has lost lots of weight, without the icky side effects of Lithium. Even at a low dose of 50 mg. a day, my depression stabilized and the side effects lessened. I didn't have tremors or anything else associated with Lithium. I realize 100 mg. a day is a low dose, but I feel that the recommended dosages of a lot of meds are set by the pharmaceutical companies - and lots of times a lower dose will work just fine.
Good luck to you. B.
Posted by Cynthia on March 14, 2000, at 11:28:57
In reply to Re: Topomax as mood stabilizer?, posted by Brenda on March 14, 2000, at 10:15:03
Hi - I am on 400 mg of Topomax a day for rapid cycling Bipolar I. I have noticed a dramatic decrease in appetite but not significant weight loss yet ( have been on it for a month) I am staying with it and hope that it will help with the weight gain caused by previous psych meds. I have also noticed a decrease in headaches , a bonus!
Posted by Ginny on March 14, 2000, at 11:58:35
In reply to Re: Topomax as mood stabilizer?, posted by Brenda on March 14, 2000, at 10:15:03
> > I have read that Topomax has been used as a mood stabilizer and is associated with weight LOSS, rather than weight GAIN. Anyone have any experience with this? I am atypical Bipolar II with extreme fatigue symptoms when off meds (or when on the wrong ones).
> >
> > Thanks!
> >
> > KarenB
>
> Karen - I was on Topamax 100 mg. for about 3 months as a mood stabilizer. It DEFINITELY caused weight loss. If you have hypoglycemia it's important to make sure you eat. The most annoying symptom I had with this med was ringing in my head and a sensitivity to noise. I was having a Major Depressive episode and the Dr. thought I was BPII. It did help with the depression. However, I noted a lack of creativity or rather a desire for creativity. That feeling, though, could also have been a result of the depression. It's hard to say. I quit taking the Topamax and stabilized on Zoloft alone. My creativity is back - and the suns out again, too. It's probably all tied together. I have a cousin who is BPI and on Topamax and Depakote and she has lost lots of weight, without the icky side effects of Lithium. Even at a low dose of 50 mg. a day, my depression stabilized and the side effects lessened. I didn't have tremors or anything else associated with Lithium. I realize 100 mg. a day is a low dose, but I feel that the recommended dosages of a lot of meds are set by the pharmaceutical companies - and lots of times a lower dose will work just fine.
> Good luck to you. B.
I've been taking topomax for almost 2 weeks now to prevent migraines. I've been gradually increasing the dosage until now I'm taking 200 mgs a day. At first I was having a pretty difficult time with simple things like math, and I don't know, understanding simple things. It was crazy. It's becoming a little clearer now thank the Lord. Had me worried. It's helping with headaches too. Slowly though. As far as the weight loss goes, the first few days was great, I lost 3 or 4 lbs. If kind of goes up and down. Sometimes I go from being disgusted by the thought of food to being starved. I don't know. Today and yesterday I've been hungry but the monthly visitor is on the way so maybe that has something to do with it. I'm really hoping for the weight loss to work for me. Anyway, good luck to you! Ginny
Posted by Anna P. on March 14, 2000, at 16:02:21
In reply to Re: Topomax as mood stabilizer?, posted by Ginny on March 14, 2000, at 11:58:35
> > > I have read that Topomax has been used as a mood stabilizer and is associated with weight LOSS, rather than weight GAIN. Anyone have any experience with this? I am atypical Bipolar II with extreme fatigue symptoms when off meds (or when on the wrong ones).
> > >
> > > Thanks!
> > >
> > > KarenB
> >
> > Please tell me all about the cognitive problems caused by the Topamax. I have the irrational fear of that medication, as I was always proud of my memory.Anna P.
Posted by Cam W. on March 14, 2000, at 17:37:06
In reply to Re: Topomax as mood stabilizer?, posted by Anna P. on March 14, 2000, at 16:02:21
Anna - The cognitive problems with Topamax are usually seen at the beginning of therapy, especially if the dose is raised too quickly. Also, cognitive problems have been seen at high doses. Starting dose is usually 25-50mg daily and increased by 25-50mg every 5-7 days. These effects usually disappear within the first month. The cognitive problems have been described as abnormal thinking, slowed thoughts, decreased cognition, intermittent difficulty calculating, dulled thinking, and blunted mental reactions. Hopefully some of the people who have used Topamax sucessfully will post to alleviate some of your concerns. Just because a drug can cause these problems, it does not mean it will happen in everyone. Also, I will repeat, the cognitive problems usually resolve within the first month. Good luck - Cam W.
Posted by judy on March 14, 2000, at 20:21:15
In reply to Re: Topomax as mood stabilizer?, posted by Anna P. on March 14, 2000, at 16:02:21
I was on it for only a couple of months along with depakote as a mood stabilizer. It's difficult to say if it caused me any cognitive problems because depakote already has that effect on me. I did lose some of the weight that was put on by zyprexa, but I also had an increase in anxiety which made me give it up rather than increase the other drugs I was on. Good luck.
Posted by Ginny on March 15, 2000, at 10:54:23
In reply to Re: Topomax as mood stabilizer?, posted by judy on March 14, 2000, at 20:21:15
> I was on it for only a couple of months along with depakote as a mood stabilizer. It's difficult to say if it caused me any cognitive problems because depakote already has that effect on me. I did lose some of the weight that was put on by zyprexa, but I also had an increase in anxiety which made me give it up rather than increase the other drugs I was on. Good luck.
I thought I had read somewhere that topomax was actually supposed to help with panic attacks. Is this not true? I was counting on this, but have not benefited from it yet. I still have that feeling of dread and panic in the grocery store and other brightly lit public places, you know the ones. (Well, some of you do, I'm sure). Cam W, you sound like you're a pharmacist or a Dr., are you? Ginny
Posted by Anna P. on March 15, 2000, at 13:45:31
In reply to Re: Topomax as mood stabilizer - Anna, posted by Cam W. on March 14, 2000, at 17:37:06
>
> Thank You Cam for Your support. I'm still affraid of trying the Topamax although my doctor has encourage me to do so. In my case nothing works for a long time, and I don't know : is it worth to try even Topamax?
Cognitive effects sound scarry to me. I'ts even worse than the weight gain, because you are not yourself anymore.Anna P.
Posted by Cam W. on March 15, 2000, at 18:33:37
In reply to Re: Topamax - to Cam, posted by Anna P. on March 15, 2000, at 13:45:31
Anna - Always be a little apprehensive about starting a new drug. Ask others for their opinion and experience with the drug. Then make an informed choice on whether to use the drug or not. Unless you are using simple math in your job, without a calculator, all the time, I would say give Topamax a shot. The cognitive side effects in most people are mild and transient (go away within a month). These side effects really should not scare you more than any other side effect (drowsiness, etc.), unless you operate heavy machinery, etc. But a drug will not work to it's full potential if you think it won't work. A positive attitude does add effectiveness to a drug's actions. The final choice is up to you. Good luck - Cam W.Ginny - I am a community pharmacist who works half-time in a mental health clinic. I also read a lot. Cam W.
Posted by Anna P. on March 16, 2000, at 15:41:47
In reply to Re: Topamax - to Anna P. Ginny, posted by Cam W. on March 15, 2000, at 18:33:37
>
> Thanks Cam. Are You from Canada? I'm on Tianeptine now that starts to work partially. That's my second option to potentiate it besides the Topamax. Do You know anything about adding the amineptine to it? Also, is is true that the use of benzodiazepams decrease its effectiveness?Anna P.
Posted by Cam W. on March 16, 2000, at 22:50:16
In reply to Re: Anna to Cam W., posted by Anna P. on March 16, 2000, at 15:41:47
Anna P. - Yes, I am a Canuck. We don't have either of those medications here, yet. I have no experience with amineptine or tianepine. Others on this board would be much better equipped to answer those questions. Start a new thread and see what you get. Sorry, I know my limits (sometimes) and don't like to guess. Sincerely - Cam W.
Posted by KarenB on March 17, 2000, at 11:25:40
In reply to Topomax as mood stabilizer?, posted by KarenB on March 13, 2000, at 22:37:12
Thank you, everyone, for your experience on Topamax. I will try it in a couple of weeks when my new AD stabilizes and see what happens. Hope I don't get any cognitive side effects but at least I know now to increase SLOWLY.
Karen
Posted by gaiagrrl on November 1, 2000, at 12:10:19
In reply to Re: Thanks for Topamax Info, posted by KarenB on March 17, 2000, at 11:25:40
hi..i haven't posted before but ive been reading this conversation because my P.Doc just prescribed Topomax to me...I was on Gabapentin and Epival (Im Bi-Polar) but I have had major side effects with weight gain and the cognitive stuff that so many have talked about. My doc thinks it was the Gabapentin that caused the cognitive problems that just didnt go away...made me feel so slow and stupid all the time..I hate it. Do you have any idea whether Epival and Topomax have worked well together in the past?
Posted by gaiagrrl on November 1, 2000, at 12:32:18
In reply to Re: Topomax as mood stabilizer?, posted by Cam W. on March 13, 2000, at 23:05:25
cam, boy you have a lot of good information, thank you for posting it...its really informing me around what questions I should ask about Topomax to my PDoc when I see him next. The specialist that has prescribed Topomax has got me on a 25 mg dose going up over a period of 2-3 weeks to a dose of 100 mgs...is that a really low dose?
My main question actually had to do with your mentioning the obesity study with topomax in Ontario - seeing as im a southern ontario girl myself - and unfortuntately, due to the meds from the past three years, now clinically obese, (ive gained 100 pounds in 2 years) - is there any access to the public about this study - any where I could read about it? Just wondering...
Posted by Mary B. allen on December 8, 2000, at 14:35:06
In reply to Re: Topomax as mood stabilizer?, posted by judy on March 14, 2000, at 20:21:15
> I was recently put on Topomax 300 mg a day by Dir. of a Pain Man. area. He told me that this would help with sleep, and pain relief along with the Neurotin (800 mg x 4 times a day). I had recently come off high doses of Mepergan Fortis and MS Contin., and I wanted to seek other opinions about the use of this drug. I saw a Psychiatrist after I came off all the pain medicine and this physician told me that I don't have any problems that she notices (no depression, no panic attacks etc...) So, it worries me that this drug is for mood altering and bi-polar folks...at least that's what I'm reading at all these web sites....does anyone have any experience with their pain mang. folks in prescribing this drug...to augment neuropathic pain and to help sleep...I was on Neurotin and Tegretol (400 mg at night...and still no sleep). I was also warned that my sleep paterns will be affected for some time coming off the drugs, Ms Contin etc....Pls write and let me know of any experiences... Many Thanks.
Posted by KarenK on December 13, 2000, at 18:35:48
In reply to Re: Topomax as a pain relief sleep aid?, posted by Mary B. allen on December 8, 2000, at 14:35:06
I take topamax, depakote, and prozac. It takes the edge off the depakote munchies but it doesn't work well as a sleep aid. In fact, the last time my pdoc tried to raise my dose my sleep was so light it was hardly worth the time. I had to go back to the lower dosage.
KarenK
> > I was recently put on Topomax 300 mg a day by Dir. of a Pain Man. area. He told me that this would help with sleep, and pain relief along with the Neurotin (800 mg x 4 times a day). I had recently come off high doses of Mepergan Fortis and MS Contin., and I wanted to seek other opinions about the use of this drug. I saw a Psychiatrist after I came off all the pain medicine and this physician told me that I don't have any problems that she notices (no depression, no panic attacks etc...) So, it worries me that this drug is for mood altering and bi-polar folks...at least that's what I'm reading at all these web sites....does anyone have any experience with their pain mang. folks in prescribing this drug...to augment neuropathic pain and to help sleep...I was on Neurotin and Tegretol (400 mg at night...and still no sleep). I was also warned that my sleep paterns will be affected for some time coming off the drugs, Ms Contin etc....Pls write and let me know of any experiences... Many Thanks.
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