Topamax

[Spanophile]

I hear that Topamax is good for cycling and keeping Lamictal caused hypomania/cycling in check. Plus it doesn't cause weight loss. Has anyone had good results with Topamax? Lamictal has caused me headaches too and I heard Topamax can help with that too. It sounds like it could really help me with what has been going on since I've been on Lamictal. The Lamictal has stopped me from being depressed - although I have been in some mixed states (I had no clue those existed until someone on here told me that was what I was going through). I need this stuff to stop and I'm willing to try anything to get there. Well, as long as it doesn't cause weight gain because all of these psych drugs cause that for me!!

[Loon-A-TiK]

topamax has been helpful for some people as a mood stabilizer, and for others not. it seems to be rather hit-or-miss in that regard. it will help with headaches, and will probably not make you gain weight- you may lose weight. however, there are drawbacks, at least for me there were, and that's why i don't take it anymore.

it put me into a high hypo/low manic state and i didn't sleep for about 2 weeks. during that time i was a wound-up energy ball sizzling inside with energy and stress. then a bump up in my risperdal brought down the mania, but i was still that energy ball. i still slept very poorly and couldn't eat. then my hair started falling out a lot. taken altogether- that it made me manic and made my hair fall out- the former being a big deal and the latter not as big of a deal- i cut my losses with topamax. i was up to 100mg/day, and many people on it take a much higher dose than that. it just wasn't for me. we're all different. some people around here have glowing reviews of topamax, like i have glowing reviews of lamictal. oh, and it did make me stupid too. so i was calling it dope-a-max, like a lot of people do.

i don't see why your pdoc wouldn't let you try it, but don't pin your hopes on it completely. just see if it works. it wasn't worth the price to me, but it may work really well for you.

ps- it is odd that lamictal is causing you to cycle more- normally it is used to treat rapid cycling. the headaches are a common side effect, and usually go away within a couple of months. you're on a fairly low dose, would you consider going higher? or do you think that would be a bad idea? just raising the point.

[Spanophile]

I think that part of the reason I'm having this "episode" is because I'm still on Cymbalta and AD's do that to me. I'm up to 100mgs on the Lamictal. I read somewhere that Topamax is good for cycling too? I'm just afraid that I will get put on an anti-psychotic because I have strange thoughts when I go up sometimes. I do not want to gain anymore weight so I want something to stabilize me before the pdoc puts me on Seroquel or something. I need no more weight gain - I went from 170 to 225 after I started taking all these drugs.

[Loon-A-TiK]

yeah, definately, your headache issue could be from cymbalta withdrawl. i tried to give up paxil 3 times before i succeeded. i had to go down to the liquid form to get off of it, it was that bad. i love paxil too, but it killed my sex life

topamax is hit-or-miss when it comes to helping with mood disorders. YMMV. it just depends on your body and how you respond to it. some people love it with no side effects, and some people, like me, get manic and have side effects. go figure.

lamictal and topamax are both not going to cause weight gain, or at least, they're unlikely to. lamictal is weight-neutral and topa can help with weight loss for some people. i lost a few lbs taking it, and i wasn't on it for very long. now, my weight loss could be attributed to the fact that my hair was falling out and thus making me lighter, but that's a different story

so, in short, you didn't gain the weight from lamictal. and you won't from topa. just ask your pdoc about trying it. aren't you bipolar? i'd just watch for mania, like what happened to me. you might want to consider increasing the lamictal too. 100 is a rather low dose for controlling bipolar disorder.

loon

[crazynotstupid]

Well. First off--topamax is generally used for migraines, not "normal" headaches, and I don't know if your headaches would be closely enough related to have any impact.

Anecdotal evidence has it that topamax is just swell for some ultradian cyclers, but aside from that many pdocs are of the opinion that it doesn't make a good anti-manic. Fer instance, the Texas Bipolar Algorithm Project has seven levels for treating mania. Topamax is level 7--right after ECT! Maybe with time and more anecdotal, and then studied, evidence, this will change.

A question--why aren't you considering other mood stabilizers? There's lots out there, and any may well be more effective than topamax. And cheaper!

And, I'm going to agree that you're on what would be considered less than the usual therapeutic dose of lamictal--200 being the norm. Of course, if that's all it takes to kick your depression, more power to ya! But definately consider the range of anti-manics. Topamax is a picky drug and tends to work best for those with the right flavor of brain cooties. I only liked it cuz it worked so well for my needs, but I wouldn't suggest it as a starting point.

[Dee]

Topamax was just added to my cocktail too. We're giving it a shot to address my rapid cycling. If it helps with impuse control (binge eating, chain smoking, popping extra pills) that would be a bonus. I wanted to give it a shot before moving from Trileptal to Tegretol, which is my pdoc's next course of action (I'm not keen on that).

I'm starting low, 12.5 mg for the first week since I'm already on a pretty big cocktail. I noticed after it kicked in yesterday that it really quieted my brain. For those taking it, will this awesome effect stay with me at a higher dose?

How's it going for you Spanophile?

[Velvet Elvis]

That's a baby dose for sure.

It's hard to describe what it's done for me other than, that it's chilled out a part of me that really needed it and nothing else would touch. It continues to help with anxiety to the degree of my not needing an AP at higher doses. It turned my tourette's off like a lightswitch. Nightmares are gone. OCD is lessoned. The downside is a loss of about 10 IQ points.

Cavet: I'm not BP.

[Dee]

That's a baby dose for sure.

It's hard to describe what it's done for other than, that it's chilled out a part of me that really needed it and nothing else would touch. It continues to help with anxiety to the degree of my not needing an AP at higher doses. It turned my tourette's off like a lightswitch. Nightmares are gone. OCD is lessoned. The downside is a loss of about 10 IQ points.

Cavet: I'm not BP.

That's good to hear. That sounds like what I'm referring to, a chilling out of sort and an anti-anxiety effect that is different from what I get from a benzo. I'm already down about 50 IQ points from all the other shit I take, so what's another 10?

Hopefully it helps my cycling and I keep that brain calming effect. I'm going up 12.5 a week and then re-evaluating at 50 mg whether or not to keep going.

[crazynotstupid]

Dee, I would give it more than 50 mg myself. I never saw real benefits until 200, and my best results were at 400. While you may do well with only a low dose, it can take some monkeying to find the most beneficial dose for you.

[Velvet Elvis]

I think I did 25 for 3 days or a week and then went to 50, then to 100 a month later.

It sounds like he's using the migraine dosing schedule. Since bp is off label there are no rules, but what many people around here have taken seems to mirror the algorithms used for epilepsy.

[crazynotstupid]

I think I did 25 for 3 days or a week and then went to 50, then to 100 a month later.

It sounds like he's using the migraine dosing schedule. Since bp is off label there are no rules, but what many people around here have taken seems to mirror the algorithms used for epilepsy.

True dat. Me, I started at 50 and that was basically my titration level. Oh, and I only had thinking problems at one or two steps too.

[Dee]

We're going slowly because I tend to be "side effect sensitive". At 50 mg, if I'm tolerating it ok, then I am sure we'll go higher. It's also my GP monitoring me ATM, because my new pdoc is unavailable/AWOL. Maybe when/if I get in to see him, we'll go up faster.

I hope it works!

[Loon-A-TiK]

i don't think i mentioned this stuff before.

i only ever went up to 100mg, and that was because it already made me so manic and disturbed that it wasn't possible to go higher. i had the jitters really bad. i could hardly hold a spoon because i was jittering so bad.

i know it is a godsend for some people. i was not one of those people. i took it for a couple of months and it just became obvious that it wasn't going to help as much as it hurt. i did realize more stabilization in an odd way. what i mean is that while i was manic, i was in a stable mania and not cycling.

i get migraines from time to time, and i never got a single one on topa.

it is also GREAT for helping with a drinking problem. i'm not an alcoholic by any means, but prior to taking topa i'd have 5 or so and it always got me into trouble. on topa, one would make me feel like i was going to puke my guts up and i couldn't drink at all. when i went off of topa, i continued this good habit of not drinking so much. now on adderall i can't drink again, but it doesn't bother me. if you need help, even if you're not an alcoholic but would like to slow down, then topa is great.

[Maddy]

Topamax has done wonders for my cycling. It worked when nothing else did.

Although I take it 4 times a day instead of the usual twice daily dosing.

I'm also up to 400mg but I'm taking it for epilepsy as well.

My titration schedule was to double the dose each week, I think.

I don't really remember since it's been so long ago.

I kept all the good effects even at higher dosages. It seemed that I had more

side effects at the lower dosages. I did pretty good at 200mg for awhile. Then

I started having some breakthrough mania and more seizure activity so they

bumped me up to 300mg for a while. They upped it to 400mg in late '06 for the

same reasons.

As far as weight goes, I have a very hard time with keeping weight on. Though

it seems that this side effect tends to hit the very people who it either helps the

most and/or the very people who can least afford to lose weight. That's just been

my observation though, so keep that in mind.

As far as it changing the ways things taste, I've found that it mostly applies to foods

and food products containing high fructose corn syrup. It doesn't seem to affect me

as much now or I've gotten used to it. Though regular colas still taste nasty. Even

Mountain Dew is a hit-or-miss game with the taste buds.

Just remember to drink lots of water and don't go on any high protein diets. Your

kidneys will thank you.

I hope something in this post was helpful and sorry if I rambled too much.

[sallie21]

Hi

Topamax really put a stop to my rapid cycling, too. What a relief. It also did that "chilling out" thing that Velvet Elvis mentioned. Helped with anxiety in general and just hit on things I needed...made the nightmares stop...interesting things like that. And I quit wanting to eat everything in sight...a real problem I picked up from Seroquel. I dropped the weight I needed to and my blood sugar went back to normal.

I am BP, by the way. I know the evidence is sketchy for Topamax and BP, but I really think it has "evened me out" if that makes sense.

As for the IQ points, I don't know. I know what you mean, Dee...I think I've lost points from meds in general...and I think the BP has just done it to me, too...so who knows...but Topamax does give me a run for certain words now and then...some times are worse than others. Usually it's not *that* bad.

And none of my food or drinks taste weird. I know, I've heard of that side effect, but I have never had it.

And no kidney stones or problems...Maddy's right...drink lots of water. And I guess being a vegetarian helps there...

Take care all,

Sallie

[Dee]

Maddy/Sallie, I'm glad to hear it helped with rapid cycling. I really need SOMETHING to nip that in the bud. Lamictal makes cycling worse, if anything, but dramatically helps depression in my case.

I drink alot of water and have gone back to vegetarian. Hopefully, you're right and that does help fend off kidney stones.

As far as the weight loss goes, I know it's only an added bonus for some but it would be a nice side effect. If it kills glucose flavour, it makes sense that it "might" help with Seroquel sugar cravings. We'll see.

I'm bumping up to 25 mg today. Splitting the pill seems ridiculous. Even with a pill cutter, you can't get anywhere near a half dose. I'm having no side effects so I may as well go for it. It's been a few days

[Sophia85]

I'm on Topamax for nerve pain and I've noticed that while its not really helping my nerve pain it is really helping my mental health. It has deffinatlly improved my moods in terms of cutting down my cycling and getting my impulses under control. I went from Binging and purging 20+ times a week to not doing it at all when I started topamax.

I'm on 250 mgs a day. At first it made me drowsy but that side effect went away. The only lasting side effect that I've experienced is that carbonation tastes like crap. Like I can't stand to drink anything carbonated at all anymore.

[Spanophile]

It sounds like I could benefit from Topamax. I have very rapid cycling on Lamictal (depression gone except for the agitated kind that comes and goes). I'm very restless and agitated period whether I feel happy or irritable so I'm hoping to find something to nip that in the bud. I gain a zillion pounds on all these meds so even if it's just weight neutral that would be helpful. I could use something to chill me out. I'm going to talk to the new psych about it. Thanks everyone for the responses!

[Alyson]

Maddy, I just have to so agree with your post.

With the weight gain issue how it does seem to work for more of us that seem to not have had issues with it, and more so need maybe to gain.

Also how with others that said too, that for us with the right brain cooties, it definitely works at higher better than lower, and with less, or no side effects.

I am now on 300 mg. and we are planning to moving to 400.

First doc in PA did it the migraine way for me and it was shit on me.

I gave up.

Then he did decide when nothing else was working, to go right to 150, then fairly quickly to 200.

My really great therapist and neurologist here in Boston shot that right to 300.

That was my sweet spot. But, now new issues in therapy, feel need to up.

No more feeling so out of my skin, wanting to go back to bad habits..and was ready to seriously do talk therapy.

Topomax really can help with so much more than manic alone.

All those brain triggers, so many things firing around.

Oh my therapist, med doc think of Topomax as first line treatment for all of that.

It was true hell before.

Now time for work.

Aly

[Dee]

So far so good with 50 mg. Pdoc wants to leave it at that for awhile because I've had too many cocktail changes recently, but said we will likely up it later.

I haven't cycled yet, but that doesn't mean anything. it's too soon to tell.

I AM experiencing appetite suppression. I'm not very hungry and not craving sweets like I normally do. I am not having the ravenous Seroquel binge urge. I'm liking that s/e.

I don't feel any stupider than I was before it was added either.

[Loon-A-TiK]

dee- have you lost excessive amounts of hair or become totally intolerant of alcohol? when i was on topa, i lost handfuls of hair and felt like i was going to puke after 1 drink! lol

[Dee]

I have only been on it for a few weeks and I am not noticing any more hair loss. I did notice an increase with Lamictal, but I have alot of thick hair, so I don't care.

I don't drink, so that is not an issue. I DO however chain smoke and I am noticing if I smoke too many in a row I am getting nauseated so I have to slow down, so maybe it will help with that.

But really, I haven't been on it long enough for a proper evaluation, just a "so far so good", sort of comment.

[Velvet Elvis]

Loon, I thought you'd determined the cause of the hair loss to be risperdal and birth control pills?

[ragemaxis]

topamax makes me low-manic / hypomanic all the time. like someone above, I didn't sleep at first and it made me really prone to getting into a euphoric state where i'd do really stupid things to "accentuate" the feelings - I ended up relapsing in a BIG way after a long period of keeping it together. I didn't so much lose weight on it as my entire body shape changed, I got leaner and my face and muscle mass kind of compacted. I'm still hovering around 220-230 most of the time but most people say I look alot more trim and i'm down a pants size. I eat totally differently now and I quit soft drinks.

Sugar, amphetamines and other "dopamine highs" do absolutely nothing to me. I got major cognitive issues and memory problems at lower doses. I'm in a bit of a constant haze and have a bit of trouble communicating now at times. I tend to be really out of it. I also had major issues with navigation and lost alot of my skills - as if big parts of my memory and cognitive skills had just disappeared to another part of my brain.

Cycling wise it appeared to put me into this hypo and keep me there, except now I occasionally spike MASSIVELY DOWN from time to time. I was prone to major problems with dysphoria at the 125-150 range. I'm at 200 now (and on lamictal as well). I get tremors and jerks and occasionally (when my potassium is iffy) I get myclonus and some weird stuff where I feel like my body's power is turning off and i'm falling for a millisecond or so. Never happened before topamax.

I never want to eat really, I have to be stoned or on seroquel or looking at a food poster to want food. But this has lessened ALOT ... it was really potent at lower doses. Most of the side effects have diminished.

My teeth have rotted right out on topamax. $4200 in dental work last spring, but bear in mind i'm an ex-junkie and my teeth weren't rosy. But... it was the last straw and a big part is the super dry mouth all the time. Gotta 5 minute brush twice a day. And use a good quality non alcohol mouth wash or else it rots out the gumline into big nasty ruts you can feel and see all around the gums. Gross. And stinky.

Mood wise the effects have more been on impulsivity, rage and compulsive behaviors than cycling. ALOT of people think its useless for bipolar. It seems to work on total oddball people who don't do well with other drugs.

If you're taking it just to avoid weight loss ... hmm ... I don't know what to tell you. Good luck with that.

Thats why it was perscribed for me though - and I'm not sure how good a fit it was. It helped me quit binge eating but the year of constant hypomania turned me into a raging freak and scared off all my friends - before that I was known as a mellow burnout - and now everyone thinks i'm an over-intense spazzy freak. It had a PROFOUND effect on my personality and alot of people have given me feedback to the extent that it really altered my personality and they don't want to be around me now - stuff like ... what happened to the old greg? ... YMMV.