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I have heard of some studies done in which Topamax has been investigated for the efficacy in treating alcohol dependence, cocaine dependence, etc. (I don't have any citations off the top of my head, but after college I worked in an addiction research center, and one of the psychiatrists was running a study on using Topamax for treatment of alcohol abuse. I have also separately heard that Topamax can help with "impulsive behaviors" in general (binge/purge, self-harm, etc). Has anyone ever used it for purposes of reducing substance cravings and/or specifically to target impulsive behaviors? I have been struggling with substance abuse (DXM/"robotripping") with increasing lengths of abstinent time, but still using impulsively and having cravings. I also struggle with self-harm and binging behaviors with very rare purging (hx of full blown bulimia-- I'm afraid with increasing sobriety (12 days clean) that my ED and self-harm behaviors will exacerbate. I was on Topamax before for about 10 months, and it seemed to have a positive impact on my binge eating, at the very least. I was not having substance use problems then, so I can't comment with that. It probably helped with mood stability to an extent. (I'm not bipolar, more like borderline personality traits or full blown BPD, depending on which provider you ask, so a mood stabilizer is not imperative nor are medications the cure-all). And to top it off, I had less frequent headaches (working with gdoc to figure out if the chronic headaches are migraine, tension, or combined). And the Lamictal headache had not seemed to truly go away-- I always have at least a dull headache to an extent. My current pdoc doesn't have much experience with Topamax, so that was part of the reason for the switch from Topamax to Lamictal. (The other reason was I wanted to go on the BC pill, but boy was that a disaster!) I was thinking about talking to her about Topamax again and seeing if we can trade out the Lamictal for the Topamax. But I wanted to get some feedback about whether anyone here has used it for addiction, self-harm, binge eating/EDNOS, PTSD and BPD symptoms, etc. Thanks!

Hi All, I have posted on here awhile back before but haven't been back. I don't know, maybe I feel like I don't have a "real" addiction, like this is more of an "acting out" thing and/or a BPD self-harm thing than actual "addiction." However, over the past 18 months of so, I have struggled off and on with DXM abuse (cough medicine that has a dissociative/mild hallucinogenic effect, maybe like ecstasy... don't know for sure because I have never tried ecstasy or "harder" drugs than pot.) I am embarrassed because this is commonly abused by mainly teenagers-- and I am 30 and never used it as a teen. I am also embarrassed because I work as an addictions therapist and, well, I am struggling with substance abuse (and its like some of my colleagues in recovery who may relapse-- I never had this problem to begin with.) I actually think both of these reasons contribute greatly to my urge to abuse this (or any, I guess) substance. It feels like a very rebellious defiant adolescent part of me that is driven to do these behaviors-- because I grew up "too fast" due to trauma stuff, had a very restrictive household, and didn't get the opportunity to experiment with drugs as a teen (maybe driving my choice for that substance in particular-- although it could also be because of lack of access to other drugs because I am so socially isolated that I don't know how to obtain drugs). Also, my use of this substance started very shortly after a work-related traumatic event...and somewhat of an irrational sick sense of jealousy of my clients (maybe for having a more "tangible" problem than addiction rather than complex trauma which hasn't seemed to have a clearly defined recovery path or support groups or IOPs or anything like that thus far... yeah, I know irrational and distorted and probably insensitive to people with "real addictions" but that is how I emotionally feel, not what I truely believe). I am baffled by my continued use of this substance, as I no longer get much of an effect from it at the doses I do (and I am terrified and unwilling to do more) and when I do feel an effect, it is largely negative. I don't enjoy it and never really did, don't crave it physically. I also haven't experiences much "consequences" of my use, which makes me worried that I don't have too much motivation to stop. My consequences are: weight gain/bloating/stomach effect from the substance, spending money on something pointless (not to to point of even remotely causing financial problems), and sense of self-shame. No one in my life knows (except my MH team, which is monitoring me), I don't use in front of other and if I am somewhat under the influence it is not noticeable to my family/SO, it is (questionably) legal, etc. But I do want to stop because I feel it does interfere with my emotional well-being (if for no reason other than the shame factor), want to be healthy, and want to focus on accomplishing higher level goals. I know it's typical for people to say they are on a "downward spiral". However, for me, I feel I am on a slightly "upward spiral"-- that is, I've been able to abstain from increasingly longer periods of time (4 to 7 days versus using daily or every other day). But, of course, my goal is complete abstinence. I'm not sure how to achieve this. I have been trying to track my "sober days" and create a reward system for myself for each sober day, with increasing reward for increasing length of sobriety. Maybe that has contributed to my increasing length of time between uses? I don't feel like AA/NA is an option for me, due to 1.) risk of running into clients at meetings (even if I went a little further away, I have worked in other facilities farther out in both directions, and I would still run the risk of seeing former clients), 2.) embarassment over not using a "real drug" and feeling the need to be dishonest about what I use, and 3.) some issues I have with 12 step model in general. I have been dusting off the DBT skills to reincorporate my skills into my life, and I think that has also been helpful in my recovery. But any suggestions you have, the better. Thanks for reading if you made it this far. P.S. I have a MUCH harder time resisting when I am about 7 to 10 days premenstrual just like with food cravings (and do have a PMDD diagnosis), so any suggestions for during this period (no pun intended) are also appreciated.

Hey All. I have never posted in this forum before, and this is something I am EXTREMELY ashamed to admit to. For a little over a year, I have been abusing DXM tablets (i.e. dextromorphan, "robotripping") off and on. It started because, after a traumatic event at work which left me jobless and re-triggered PTSD, I just wanted to get out of my fucking skull for a bit-- I actually wanted to smoke weed, but I was so socially isolated in a new city (well had lived there about 1.5 years) that I didn't even know how/where to buy weed, so I tried this for the first time as a legally obtainable alternative. Though I know of course it's unhealthy, I used as much "harm reduction" as possible (i.e. buying the pills that ONLY have DXM in them, rather than ones contains like acetaminophen, decongestants, guafenasin, etc). I was generally using 1 to 2 bottles in a sitting a couple time a week, then up to 5 or 6 times a week, starting in Aug 2012 and quitting in Nov 2012. I quit before through willpower and by telling my friend, who forced me to tell my therapist and my psychiatrist, and I quit mainly because it caused me to gain some weight, the trips were becoming unpleasant, and it was a waste of money. The telling to someone made me accountable. I started doing it again here and there this past April 2013, shortly after getting a job and probably in response to job stress and triggers. (Possibly also in response to living with my parents again and wanting to escape that-- 1.) my parents were emotionally abusive to me in childhood and we had a rocky start with me coming back here, and 2.) living here makes me feel about 13, and OTC med abuse is a very teenager-y thing to do.) It started out as something I did maybe a couple times in a month but is now back up to 3 to 5 times a week, mainly only at one bottle. I've stopped doing the 2 bottles because it became unpleasant and I hated the feeling of loss of control. Sometimes I do this behavior in response to a stressor, other times just boredom, but I've found that many times it's out of a compulsion, as I really don't feel much of any effect. I feel at this point I am mainly addicted to the "process" of taking a bunch of pills, and in a sick way I somewhat like the physically ill feelings (i.e mainly diarrhea and stomach issues) I get from taking them (which is about the only effect, as I refuse to go higher). I have a history of bulimia (initially through laxative use), but I know I'm not doing this to lose weight because DXM actually increases my appetite-- but part of the bulimia was being more addicted to the "purging" (whether through laxatives or vomiting) than the food (i.e. I binged so I could have an excuse to purge, not purged because I lost control and had binged). So, is this an substance addiction thing? Is it more of a self-harm thing / trying to relive the bulimia experience? Is it kind of an OCD/compulsive thing of being addicted to the behavior more than the substance? I have also been engaging in other ritualistic/compulsive behaviors, like feeling the need to go to Starbucks at the same time daily to get exactly the same thing each day. (Another aspect of ritualistic Starbucks behavior is it gets me out of my work environment and far enough away from the building, as my work can get very stressful). I don't experience ill effects physically (or even mentally per se, like depression which is common in DXM withdrawal) when stopping use. I just have strong mental cravings and compulsions to go do i again. I am not depressed at all currently, my life is going pretty well, and my PTSD symptoms are at bay. Why am I doing this? I have no history of substance abuse or dependence-- I do have history of ED and self-harm (none current), which I can conceive of as addiction, and vice versa. How can I stop? (I have tried "playing the tape" and reminding myself of the consequences-- physiologically, psychologically, socially if people found out, career wise if people found out, risk for serotonin syndrome, etc-- but apparently that doesn't work.) Meetings seem to be out of the question, as I work as a therapist in the addiction field (another huge reason I feel ashamed) so would run into clients if I go to any meetings within a 30 mile radius. Plus, I have been to meetings for work purposes, and I haven't heard ANYONE share about this issue-- others' issues seem to be more severe and involve "real" drugs." I am terrified to tell my new tdoc and pdoc about this, as I don't know them very well yet. I am afraid they will make me go to IOP or something (again, can't do that anywhere locally because of being in the field and running into either clients or colleagues), and I am terrified my pdoc won't prescribe me benzos anymore. (My last one when I told her about the DXM started trying to taper me off of benzos, as she assumed that if you are addicted to one thing, you'll abuse anything-- I have never abused my benzos). I also can't see my pdoc and tdoc until Nov 1 or later because I am without insurance for a month. I guess if I can't stop this on my own (without at least the support of an online forum), I will have to tell them. Any behavioral suggestions I can do? I am especially scared in the immediate moment because I have to go to a pharmacy TODAY and pick up 2 prescriptions (one which I absolutely need today). Plus, I am sick with a cold and cough and would benefit from some kind of cold medicine while I am there-- we don't have any at home. I am scared I am going to give in and get a bottle of generic robotussin pills while I am there. Thanks for reading. I am just so embarassed and ashamed, especially being that I work in addiction field and that I am "too old" for this problem (almost 30). Edited for: Removing more trigger-y stuff