Topamax

[MaryPoppins]

I'm being rapidly weaned off of Geodon because of neurological problems like shaking, tremors, and a stiff tongue. Fun, right? Anyhow, I'm slowly titrating onto Topomax. Are we really speaking of severe cognitive issues? I'm a full-time student, and I'm just pretty worried about the effects of Topomax. Anyone out there on Topomax who isn't a drooling village idiot? Please let me know that I'll be ok. LOL!!!

[newbie9999]

The first few days, I was an idiot, but then things got better. I am on 100 mg and have barely any cognitive issues. Every so often I will forget a word, but I figure everyone does that sometimes! So, my experience has been a good one so far. Good luck to you.

[SashaSue]

The first couple of weeks were pretty bad, but now I'm on 400mg/day, and have been for several months, with no significant cognitive issues.

[SashaSue]

The first couple of weeks were pretty bad, but now I'm on 400mg/day, and have been for several months, with no significant cognitive issues.

[CrazyLee]

I started at 25mg and had village idiot issues but was so stupid i didn't care. I am titrating up to 50, then 75. I forgot someone's name today who I know quite well.

[crazynotstupid]

Topa had hit me, at certain dosing points, kinda hard (OK once I forgot my name). But other than that it's been quite benign--just little things. The basic thing, I've found in my time on the boards, is this: if your brain is built for it it will treat you well. Otherwise it may very well hose your ass. But really, for a long time I have heard a really low level of bitchiness about it.

[Silver]

I've done much better with it at 175 mg+ than I ever did at the lower doses.

I do still have a tendency to have a sudden Really Good Idea, then lose it within 5 minutes. Also, I promise to do things, and it just doesn't stick to my brain. I'm usually a conscientious person. So I've turned into one of those people who carries a little notebook. It helps. (Maybe it was inevitable anyway in my late 30s.) If I write down a few words, I can reconstruct the rest.

So- intermittently ditzy, but not stupid.

CNS: you forgot your name? OK, I feel much better now about losing my way home repeatedly (and I live in the sticks, it's very hard to lose my way home.)

[Anelize]

At one point, I was on it for about 2 years--at 600mg a day. The first month or so, I had wicked memory loss, but it resolved. The word finding thing didn't though. In fact, I've been off it for a couple of years now, and I still have some minor word finding issues. But, the stuff worked great when it worked....

[crazynotstupid]

I do still have a tendency to have a sudden Really Good Idea, then lose it within 5 minutes.

I've had that prob all my life. Only now can I blame it on meds or age.

CNS: you forgot your name? OK, I feel much better now about losing my way home repeatedly (and I live in the sticks, it's very hard to lose my way home.)

Yes, at the bank, filling out a withdrawal form. Took me a couple minutes to remember. i mean I knew my account number and all. Then I forgot how to sign it...until I realized no one can read my sig anyways. (hell, I could have just pulled out my license...) I live out in the sticks too and for some time thought I'd missed my road only to realize a quarter mile later, well gee--there it is!

[Loon-A-TiK]

i was on topa for several months @ 100mg, but it made me manic so i had to get off of it. it did resolve the migraine issue and curbed my social drinking to nothing, which saved me money and hangovers.

anyway

topa did make me kinda stupid. i was worse than i usually am. all my meds hit me in a fun way and take off a few IQ points, but i think topa topped the list.

the way home from work was easy, and i'd done it a million times, but somehow i ended up taking east and not west on the highway, resulting in a DRIVE FROM OHIO TO PA!!! i couldn't figure out how to get back, so i kept driving and driving, and realized i was on my way out of the state and thought about stopping for directions. the gas clerk just looked at me a little funny, and i realized i was still wearing my work badge.

i forgot my name, really. topa made me worse than Li did, and i thought that stuff was trippy.

at work, i couldn't remember anything. i had to write it all down. i walked around with a notebook to do my job. i got fired, probably for being stupid. then i got a new job and had to do it again. then my SSDI came in so i quit my job and have been on SSDI with the odd job here and there ever since (about a year and a half).

i applied for, and received SSDI while on topa. it was probably the worst med i've ever taken.

it

1. made me manic

2. took away my weekend fun at the club (it did, but i'm playing about seriously caring)

3. made me seriously stupid

i take it back that it was teh WORST med i've ever taken. i reserve that honor for Geodon.

[nalgas]

Topamax made me smarter. My memory got better while I was on it, and it was the only thing that's ever done more good than bad for me. For the six months or so that it worked before it gave out on me. It was pretty great during that time, though. Actually, just to be even more annoying, it made me stop getting hangovers, and I could actually have more than a drink or two now and then without getting a brutal headache. And that was on anywhere from 300-500mg/day. Heh.

[Alexis@imaginet.co.za]

I was on Topamax for 10 days. Days of hell. Lost my mind, could think but not type. Got confused. Dizzy. Sweats, name it.

New psychiatrist told me that it is no longer indicated for bi-polar, but for alcoholism and kleptomania etc. Put me back onto Seroquel but increased to dosage.

Funny stuff Topamax it affects people differently. Some people "spark" on it and others become dull.

A.

[nalgas]

New psychiatrist told me that it is no longer indicated for bi-polar, but for alcoholism and kleptomania etc.

Err, and seizures, since, you know, it is an anticonvulsant and everything, and that's what those are for. Heh. And it's actually used for migraine prevention more than any other uses these days.

[dangergirl]

I love my Topa - love it! Until I hated it - and now I love it again I switched from Seroquel bc I was so zombied out and couldn't function, so it was waaay better than that. I did notice some stuttering in the first 2 wks or so and forgetting some words. I stlll forget some words and it's definitely worse than before the meds. My pdoc doubled my dose a few weeks ago and it made me manic and crazed and miserable, so dropped me back down again (I was at 100, went to 200, back to 100). I never experienced any other side effects (weird food things, weight loss, tingle hands and feet, etc) until the double dose and now that I'm back down, damn if my feet won't stop tingling. It's really, really irritating, actually, but I'll take it over the whacky mania. I just double checked w/my hubby and he says that I'm smarter with Topa, for what that's worth .

[crazynotstupid]

New psychiatrist told me that it is no longer indicated for bi-polar, but for alcoholism and kleptomania etc.

Technically not indicated for bp. Offlabel, and really so for most pdocs. While it is THE fancy new med for lotsa pdocs, older skool docs don't tend to like it at all. It seems to have a rather low efficacy for bp (I'd certainly like to see studies, if anyone knows of any). My pdoc is rather amazed at how effective it is for me--truly it is my wonder drug. It hits all three major "hot points" with minimal side effects. Truly cool shit.

Point also being missed along the way here, i think, is that often topa can have majorly different effects at even small dosage changes. At 200 you might feel kinda OK, at 250 holy SHIT you feel like HELL but at 300 you're perfect! Yeah, it's that wierd. Me. I do OK at 200, not great at 300, operfect at 400. Anything else I might as well not take it at all.

[dumdum]

Point also being missed along the way here, i think, is that often topa can have majorly different effects at even small dosage changes. At 200 you might feel kinda OK, at 250 holy SHIT you feel like HELL but at 300 you're perfect! Yeah, it's that wierd. Me. I do OK at 200, not great at 300, operfect at 400. Anything else I might as well not take it at all.

Ditto. I went thru the exact same thing while titrating up to 400mgs, then all was good. Now I'm going through the holy SHIT stage again becuz I'm titrating down in preparation for my VEEG on Monday. Needless to say I'm not thrilled my Epileptologist is making me do this just so I'll be a good little patient and seize away while on candid camera next week.

Topa. withdrawal sucks out loud.

[verti_goat]

What is the titration schedule for Topomax? And has anyone noticed if the rate at which you titrate up on Topomax influenced the side effects (for example like Lamictal)? I too am curious about the dopehead effects.

[pickles]

What is the titration schedule for Topomax? And has anyone noticed if the rate at which you titrate up on Topomax influenced the side effects (for example like Lamictal)? I too am curious about the dopehead effects.

Slow.

Seriously - the slower you go with an A/C, the greater chance you have for success. Your doctor will give you guidelines, but if you want some ideas about dosing for discussion with him/her, I would suggest looking here under 'Topamax'.

pickles

[nalgas]

I went up 50mg per day per week (i.e. start at 50, go up to 100 a week later, 150 a week after that, and so on) split half in the morning and half at night, and I didn't really have much in the way of problems doing that. I had the tingly hands/feet thing slightly now and then as I was changing the dosage, but whenever I stopped at a particular amount, it went away. Some people go slower than that, like by 25s. I wouldn't go faster.

[verti_goat]

Thanks for the info and advice on dopamax; I've already read the info on CrazyMeds.

Keep us informed on how it goes and good luck Mary.

[anonymousguest]

I am on 200mg of topamax and have zero cognitive effects from it. It's working very well for me.

I titrated very slowly. I took 25mg per day for seven days, then 50mg per day for seven days, then 75mg per day for seven days, then 100mg per day for seven days. After one week at 100mg (50mg am and 50mg pm) I went to 200mg (100mg am and 100mg pm).

[nalgas]

I titrated very slowly.

I was totally in agreement with you on that until HUGE ENORMOUS GIGANTIC LACK OF SLOWNESS suddenly popped up:

After one week at 100mg (50mg am and 50mg pm) I went to 200mg (100mg am and 100mg pm).

It sounds like it all worked out in the end, but way to throw caution to the wind after a very careful and calculated beginning. Heh.

[anonymousguest]

I was totally in agreement with you on that until HUGE ENORMOUS GIGANTIC LACK OF SLOWNESS suddenly popped up:

eh So maybe it did turn me into a dumbass after all....

[verti_goat]

so maybe it did turn me into a dumbass after all...

My pdoc just put me on Topamax and he said in his experience its hit or miss on the dope-a-max factor. Titrating super-duper slow really didn't make a huge difference in his experience. But it does help for migraines, which I also suffer from but I've noticed a difference even after just a few days at 50mg.

[nalgas]

My pdoc just put me on Topamax and he said in his experience its hit or miss on the dope-a-max factor. Titrating super-duper slow really didn't make a huge difference in his experience.

It is hit or miss in the sense that it can be kind of unpredictable whether it'll happen to any given person if they take it. Going up slowly may not change whether or not that will happen in the end, but it can make it and other side effects more bearable in both the short and the long run. If you give your brain/body long enough to adjust between moderately sized increases, you don't usually get hit as badly by as many things at once. I mean, some people might be able to rush straight to 400mg/day, be fairly broken for a month or so, but turn out fine in the end eventually, but if you can spend an extra few weeks getting there while not getting whacked in the brain quite so brutally and suddenly, it's usually worth it. The same "wait a bit and give the med and your brain a chance to make friends" advice that everyone gives out here all the time applies in the short term as well as the long term. Not letting the brain-melting side effects get quite so bad in the first place makes it easier to sit out the "I hope this gets better if I give it a couple more weeks" period, should such a thing happen, as I am currently being reminded of by starting Keppra a bit more aggressively than probably was necessary.

[LisaSCA]

i had such a problem with topamax and still do, lol, at least the stupid part. sometimes I'm completely brain dead, or at least I feel that way. Oh and I used to teach college :doh: .

If I were in college taking this drug, I'd let my profs know I was taking it, give them a summary info sheet or webpage with the side effects if they want to know more, and just apologize for any stupidity in advance. they may be willing to cut you some slack at the end. I know I would have, and I was a tough one, lol. l just wanted advance notice if at all possible. profs don't really care much about the specifics other than how you're doing and if you're okay, but they need to know if they're being conned or not.

good luck!!! hope you skip the stupids, and remember to drink tons of water (I mean tons!) . Have a ltr of smartwater (electrolytes, no sweet stuff) to help with everything.

[verti_goat]

It is hit or miss in the sense that it can be kind of unpredictable whether it'll happen to any given person if they take it. Going up slowly may not change whether or not that will happen in the end, but it can make it and other side effects more bearable in both the short and the long run. If you give your brain/body long enough to adjust between moderately sized increases, you don't usually get hit as badly by as many things at once.

Agreed 100% and that was the point of my pdoc in that some people get stupid, some people don't. Some people get stupid when they titrate up quickly and some people don't. Like you said, unpredictable.

But I was also not advocating rushing into any med. The titration schedule my pdoc has set forth is a week at 50, a week at 100, a week at 150 and a week at 200. And a weekly check-in to see how its going. Seems relatively conservative to me, but I'm just the patient and I'm just 1/2 week into it and not stupid yet

[nalgas]

The titration schedule my pdoc has set forth is a week at 50, a week at 100, a week at 150 and a week at 200. And a weekly check-in to see how its going. Seems relatively conservative to me, but I'm just the patient and I'm just 1/2 week into it and not stupid yet

That's actually the exact same thing I did, and it worked out pretty well. It was just a bit longer than it took for the minor things that did crop up, like the tingles, to go away before inflicting a new, larger amount on my brain. I would guess that that has something to do with the half-life of the med, which is slightly under a day. I seem to recall reading somewhere that you can (very roughly) estimate how long it takes to reach a new steady state when going up or down (or how long it'll take for there to be a negligible amount left when discontinuing) by taking six times the half-life, and that's been fairly consistent with my experiences with various meds, in terms of how long it takes to adjust to changes, so a week between each would make sense with that reasoning.

[verti_goat]

I would guess that that has something to do with the half-life of the med, which is slightly under a day.

Yep. According to the PI sheet, the mean (or average) half life is 21 hours and steady state is reached in about 4 days. Approx 70% of a dose is excreted in urine, thus the kidney issues/load like Lithium. So for most people with normal renal clearance, a seven day stepped dosing period is fairly conservative. But people with kidney problems would likely want start at a lower dose and increase it even more slowly.

[MaryPoppins]

I would guess that that has something to do with the half-life of the med, which is slightly under a day.

Yep. According to the PI sheet, the mean (or average) half life is 21 hours and steady state is reached in about 4 days. Approx 70% of a dose is excreted in urine, thus the kidney issues/load like Lithium. So for most people with normal renal clearance, a seven day stepped dosing period is fairly conservative. But people with kidney problems would likely want start at a lower dose and increase it even more slowly.

Yeah, my pdoc is titrating me slowly, 25 in am and 50 pm, or the other way around. It's just so slow it seems! I wish I could get out of this funk, I can't think. I'm NOT doing well in my classes. I wish I could wear a shirt that says, "I'm taking Topomax, I'm not normally this stupid." LOL! I just wish I could titrate faster and get past this. I have no kidney problems!!!!!!!

[CER]

What was the question again?

Oh yeah!

I've been on Topamax for almost a year now for migraines and it's worked well for me. I went through some forgetfulness at first (remembering names, etc..), although I think it wasn't as bad as my titration with Lamictal. Lamictal hit me hard for some reason - I would forget everything. My main side effects with Topamax have been the weight loss and the tingling feet and hands. The Remeron and Seroquel counterbalance the weight loss though so my weight remains pretty stable right now.

But with Topamax I just forget little things that drive my wife crazy...for some reason I always forget to take out the trash.

[MaryPoppins]

What was the question again?

But with Topamax I just forget little things that drive my wife crazy...for some reason I always forget to take out the trash.

I forget to take out the trash too, until the trash man is on my street, and I'm RACING out there in my P.J.'s!!! LMAO!!!! HAHAHAHAHA!

[verti_goat]

Yeah, my pdoc is titrating me slowly, 25 in am and 50 pm, or the other way around. It's just so slow it seems! I wish I could get out of this funk, I can't think. I'm NOT doing well in my classes. I wish I could wear a shirt that says, "I'm taking Topomax, I'm not normally this stupid."

Hi Mary, good to see you back. My pnurse is tritrating me up a little faster and since moving up to 100mg/day I'm feeling the tingles in my hands, feet, and a little in my lips. Maybe just a little dopey too, but I'm not working right now or doing anything cerebral so its tough to say.

Good luck with you classes. I think a big hit at the CB store would be "Got DopaMax?" t-shirts