Topamax causing mania and anxiety

[CrazyLee]

I know that sounds strange, but i have heard from a few people that they went manic; my pdoc thinks I'm manic too now. I am getting a little calmer with the topa, but I have moments throughout the day as the dose lessens in my system. I feel at my best when I have had a good dose at bed time, and good dose at breakfast. then I may get a little grouchy throughout the day, I may feel a little manicy/anxious, but by the next dose I'm fine.

I've read ofpeople (loon-a-tik- don't mean to point you out but yes you) say they went completely manic on it. I know another guy said the same thing. The slight mania I am getting at lower doses off this stuff is nice. I am happy- not raging manic- so I am not complaining.

Who has had anxiety/mania on this? Without medication I am prone to depression/ mixed states/ dysphoria/ anxiety/ mild mania hypomania.

[AirMarshall]

I did a quick search of the PI sheet and didn't find a mention of mania being a significant side effect.

Don't jump to conclusions that because you started Topomax, and that you recently became hypo/manic that the Topomax caused it.

You don't say specifically, but if you are bipolar, its possible to cycle into an episode at any time. You mention that the meds feel good and are helping right after dosing time. I would take that as a good indication that Topamax is helping. Consider that without the Topomax, your present mood might be much more out of control. It usually takes several weeks (and realistically maybe 3 months) to see the full effect of a med. It may take more time for the Topomax to take good hold, and your pdoc may consider upping the dose. Once you get the mood swings under control your pdoc may consider lowering the dose a bit (think several months from now).

Be up front with your pdoc. Don't get seduced by the momentary feelings of being hypo/manic. The crash will follow. The goal is to knock out the swings and just be smooth stable, or as close as possible all the time.

best, a.m.

[CrazyLee]

thank you,

just read a few people said they went manic on the drug, and I started going manic as I titrated up, but once i got to a higher dose I felt more level. I am liking the drug, and sticking with my pdoc. I am going to call her before the week is over and start seeing about staying at 100mg or going up in dose. I think I may need to eventually.

[crazynotstupid]

The slight mania I am getting at lower doses off this stuff is nice. I am happy- not raging manic- so I am not complaining.

This is annoying. Internet self dx'ing and term conflating at its finest. In a world where no feeling is outside the world of psychiatry, where no mood cannot be fine-tuned by pills, "happiness" equals "slight mania".

WTF? I thought "happiness" fell in the spectrum of "stability", not "mania". Mania, be it hypo or bat-out-of-hell, is happy+crack pipe. And other effects. Happiness is a warm kitten or a cold beer.

Mood disorders (e.g. bp) have specific signs; excessive happiness along with anxiety combined with other signs/symptoms define them.

I get soooo frikin' tired of people having a good day/bad day or two and thinking it's an "episode" or having good moments or whatever while just starting a med and calling them "swings".

Folks, there are mood charts for a reason. I am a diabetic--I take an a1c reading every 3 months for a reason--because I can track my glucose readings for a day or a week or a month. But to get a REAL picture of my control, hey, an a1c tells me how I do over a 3-4 month period.

My final answer: Topa ain't making you manic. possibly anxious, but I highly doubt it. If you're having any issues it's supposed to help, wait and see. Wait and see.

[CrazyLee]

This is annoying. Internet self dx'ing and term conflating at its finest. In a world where no feeling is outside the world of psychiatry, where no mood cannot be fine-tuned by pills, "happiness" equals "slight mania".

uh my pdoc pointed out she thought I was manic... I just thought I was happy. I was just talking very fast when I was in her office. Not an internet self diag here... An episode where I called someone an asshole at work made me think I might be manic. I am about say it again, RIGHT NOW, but It has nothing to do with fucking mania. Just annoyance.

let me quote myself

my pdoc thinks I'm manic too now

where does it say internet self diagnosis? Perhaps it's your internet diagnosis of me that's the problem. Clearly you didn't read my entire post that I think it IS working for me just at the lower doses I was going a bit manic under the observations of a well certified psychiatrist.

geesh

I am not reaching for a self diagnosis. It just seems people say the med triggers mania. I read it on the Dr Phelp's site too:

There is a least one case report of topiramate inducing mania.[Jochum] Here's more on Topomax, including information on risks.

Not much info on it causing mania but since someone else on the site mentioned it, and I know someone else who had the same thing happen to them. I thought I should do research.

So the curiousity that led me to this thread went as follows: I read up on med, patient reactions, some said med was great, some said made them manic, my doc prescribed med. I felt great. Started going kinda loopy at 75mg. No clue as to why this happened. Certainly wasn't anxiety as you so dismissed it as. At that point it was hypomania- which I enjoy- but my pdoc has to watch me for. In the grand scheme of my mental health how sick and how well have you known me to be? Hypomania may be nothing to you but can be the start of something terrible.

Oh back to my line of thinking. So AFTER speaking to pdoc who mentioned manic behavior (ok so this is not definitely self internet dx'd stuff) I came to mention this on the board, I thought it was just the level of med that I was at, and I mention I should go up.

Do you ever read stuff online about your meds or how people react to them? Do you ever have questions about your meds? Have you ever wanted to increase your med dose if you were experiencing something. How do you know what I feel outside of here? I realize that maybe that it was the level of med I was at that perhaps I was having breakthrough mania, or the start of a hypo/manic episode- which I would discuss with my doctor!!!

[CrazyLee]

btw as you said, and I'll quote

Mood disorders (e.g. bp) have specific signs; excessive happiness along with anxiety combined with other signs/symptoms define them.

got em- plus excessive rage at times, followed by guilt, then anxiety. It's just without the meds the anxiety usually is predominant. At lower doses the mania is predominant it seems. My pdoc- I guess they all fucken seem to do this (I don't know why) look for the mania, and the pleasure seeking behaviors first. Don't ask me, every fucken doctor I have seen tells me this. When I have said anxiety- they have given me antidepressant- I have learned with me this is a BIG mistake. I just have to beg for the mood stabilizers first- I am not a clear cut case.

[CrazyLee]

btw as you said, and I'll quote

Mood disorders (e.g. bp) have specific signs; excessive happiness along with anxiety combined with other signs/symptoms define them.

got em- plus excessive rage at times, followed by guilt, then anxiety. It's just without the meds the anxiety usually is predominant. At lower doses the mania is predominant it seems. My pdoc- I guess they all fucken seem to do this (I don't know why) look for the mania, and the pleasure seeking behaviors first. Don't ask me, every fucken doctor I have seen tells me this. When I have said anxiety- they have given me antidepressant- I have learned with me this is a BIG mistake. I just have to beg for the mood stabilizers first- I am not a clear cut case.

Also mania does not always involve anxiety, but the need for pleasure seeking activities despite the outcome. There are many variations of mania. The DSM-IV doesn't just list what you wrote.

That's why the doctor's don't usually define me as a classic bp, and usually look at me as just an anxiety case first.

[dangergirl]

Hey Lee - I was one of the people who said they got manic on Topa (borderline hypo to full blown mania)- but here's how it went down for me: I titrated up slowly to 100mg and all was well, hung out there for a while. I had undiagnosed ADD, which we were starting to get close to dx'ing, so my now-fired pdoc thought that extra Topa would help, so she doubled my Topa which made me manic. This was not just my own dx, nor an internet dx nor any kind of cyber chondria. Both my tdoc AND my pdoc said, "um, yeah, this is a bad thing and you need to stop now before you hurt someone". So I went back to 100mg and back to normal (well, normal for me). Simple as that.

During my little manic phase, both of my doctors thought I was hysterically funny and rather enjoyed our sessions. During that time I also spent nearly $1000 (in ten days) - let me remind you that I'm unemployed and was preparing for a vacation and didn't spend any of that money on said preparations (after I returned to "normal", I returned everything). When I left my pdoc's office she said to me, and I truly do quote, "ok, be happy, but not too happy". I should have that tattooed on my body somewhere it's so damned ironic. Was I anxious? Hell's NO! I was off the charts flippin happy. Everyone loved me and I loved them - the world was a wonderful happy shiny place....and then I crashed.

Only you know you and your family knows you next-best (if they live with you), then your docs. The only thing that I've learned from reading here is that everyone reacts differently to meds - no matter if it's the exact same combo, you're the exact same, height, weight, age, sex, blood line - it just doesn't matter. Brain cooties know no boundaries and follow no rules. Damn them!

[crazynotstupid]

Seems I touched a nerve. Poster hits my nerve, i shotgun a vent, what goes round...heh.

Clearly you didn't read my entire post...

Dur? I didn't? And why wouldn't you think that not only I didn't read your whole post, but not read it at least three times? It's my job! I don't do half-assed responses. Do me the courtesy of acting like I've been around the block. if you want me to respond to you like an adult--post more info. i can only respond to what you write. And believe me, I will respond to precisely that level.

Based upom your replies (all THREE of them) then yeah, I'd go with the manic idea.

At which point i'd not only agree with AM, but then say that 100 mg of topa may not be enough and more may be indicated. Myself, I'm on 200, and should be on 400. In my book 200 is a half dose, which is about as good as unmedicated. Which, to extrapolate to you, means that you may not be going through a "breakthrough" mania but are just not getting enough of a mood stabilizer and are (IMO) essentially unmedicated. Thusly, the topa is not making you 'manic' (or causing anxiety) but is merely not doing what it is meant to.

You just need more. Or, maybe something else. but, i would have been happy to have told you this with a bit more info. Sometimes I just like to make an example and go off on a tangent at the same time. Tag, you were it.

[CrazyLee]

I titrated up slowly to 100mg and all was well, hung out there for a while. I had undiagnosed ADD, which we were starting to get close to dx'ing, so my now-fired pdoc thought that extra Topa would help, so she doubled my Topa which made me manic. This was not just my own dx, nor an internet dx nor any kind of cyber chondria. Both my tdoc AND my pdoc said, "um, yeah, this is a bad thing and you need to stop now before you hurt someone". So I went back to 100mg and back to normal (well, normal for me). Simple as that.

I am titrating slowly too. Will call the pdoc. I am staying at 100mg for now. I may just go back to Depakote as I have tried it in the past.

Sometimes I just like to make an example and go off on a tangent at the same time. Tag, you were it.

CrazyandStupid, you may of read but you didn't fully comprehend it, and you had your own agenda. Go to another post, and find someone else to annoy.

[dangergirl]

Hey Lee,

I wouldn't quit on the Topa just yet - and while you may not want to hear it, CSN might have made a good point - you sometimes have weird side effects of a med that you have to wait out (like making you worse before you get better). I went into a full blown mania pretty much within a few days and stayed there. You seem to be having what I'd call "break through bleeding" or "spotting" to make the anology a little more comprehensible, if not gross (sorry) - just woke up, brain's not functioning quite right yet.

If you're liking the general effects of the med, but are having some break through moods, you may need a little bit more to reach the sweet spot. There are a lot of people here who have gone through some weird shit to get to a good dose of a med - it's part of the med go round. The difference between you and me is that you experience some good effects throughout the day, with only mild breakthroughs. Both AM and CSN have a lot more experience here than I do and did, in the end, offer the same advice. And while one hit you with a feather and the other a hammer, remember that there are a lot of crazies on here , and sometimes both methods are needed to make sure that a person is well cared for.

Um, and well, I call people assholes all the time. If there's a med that can make me stop doing that - sign me up! LOL

[CrazyLee]

but are having some break through moods, you may need a little bit more to reach the sweet spot. There are a lot of people here who have gone through some weird shit to get to a good dose of a med - it's part of the med go round. The difference between you and me is that you experience some good effects throughout the day, with only mild breakthroughs. Both AM and CSN have a lot more experience here than I do and did, in the end, offer the same advice. And while one hit you with a feather and the other a hammer, remember that there are a lot of crazies on here , and sometimes both methods are needed to make sure that a person is well cared for.

Thank you for relieving my annoyance. I just wasn't trying to be a cyber chondriac. I am crazy, hot headed, but I can think, and a cyberchondriac I ain't. I have had a bit of DSM-IV stuff thrown at me from bipolar to dissociative so, I get annoyed when people who suddenly try to tell me what I feel, and what I don't feel- without actually listening to me. Or just sum me up without knowing everything. It seems to be a problem in the psychiatric industry.

I understand the breakthrough stuff, and how I shouldn't just quit the medicine- I won't be doing that. I do trust my doctor and I have a pact to stay on medication for at least 3 months to see if it works. My doc was surprised I seemed manic- this was something she observed in me- not that I told her- so again I am not self diagnosing.

All I want is to do is discuss funky side effects of Topa since it is a newer off label mood stabilizer- it seems there are a few unknowns with it- like mania. I am level headed enough to not just quit my medication, up doses without letting my doc know or discussing it with her first, or without her explicit instruction to do so. She is at an Internationally known Hospital so I am getting some damn good treatment.

Yeah I call people assholes too all the time, I just was feeling particularly manic that day. CNS I'll be nice. I only bite sometimes.

[crazynotstupid]

CrazyandStupid, you may of read but you didn't fully comprehend it, and you had your own agenda. Go to another post, and find someone else to annoy.

Oh my. This all brings me waaay back...just after we switched to this new-fangled software in '05, the first time the "report a post" button was used, it was used to report...me. By damn, i am the most reported mod...shit, i bet I'm the most reported member there is here.

i guess I have a talent for pissing people off.

Mind you, that this is not because I fail to comprehend a post--quite the opposite; I fully comprehend, and if it duly annoys me, then yeah, you're gonna have a vein throbbing in your forehead.

In your case, lee, you just happened to leave so little explication in your original post, and I get so annoyed by so many similar posts that, well...straws and backs and all that. Had to be someone at sometime. Lucky you!

(CrazyandStupid--bit of a slip there? Eh? That first time I got reported, she PM'd me, and instead of the usual shorthand "CNS" or "Crazy" she just...called me "stupid". Some people are so silly.)

[CrazyLee]

CrazyandStupid--bit of a slip there? Eh? That first time I got reported, she PM'd me, and instead of the usual shorthand "CNS" or "Crazy" she just...called me "stupid". Some people are so silly.

You mean like trying to bait me for an arguement. And the cyber diagnosing me (which you did more of me whilst ignoring my mention of my doctor mentioning symptoms) Oh yes it was quite intentional.

And if We are going to keep on topic of discussing Topa it's going to be fuzzy beer (that tastes like ass) and cold kittens (tingly to the touch).

who's vein is throbbing now buster!

[crazynotstupid]

Actuall my beer tastes quite good, and if I could catch these damn kittens (one is a cute little siamese mix) i'm betting they'd be rather warm. And fuzzy. Side effects, no matter how common, are not going to affect 100% of all users (as I strenuously argued on another board, where the moderators were gods and would have long ago banned you. As they banned me, heh. We don't do that here--I would rather have you pissed off at me than act like i am a Greater Being. I am merely a flawed mortal. Like anyone else here.)

At any rate, thanks to the topa, i can smoke thre cigs and drive through horrendous cross-town traffic and my blood pressure is still within normal range. If you want to see me pissed off--just talk to me while I'm at work. Here, at my PC, with cold beer and handy cigarettes, I'm a happy boy.

[CrazyLee]

I remember after a dose I lost the sensation in my nose but it was all tingly. It was kinda cool. I don't drink much. I would like to drink but I get drunk easily, and I would hate to see how shit faced I would get while medicated.

[CrazyLee]

Here is an interesting quote from an article that was sited at psych education (Jochum, post #5)

We present a case of a patient taking topiramate who presented with an acute manic episode, lacking any previous history of affective disorders or episodes.

Of course I can't give more of the article without paying. If I hadn't cut up my credit card a few months ago.

Now this is not to scare someone from taking Topa. Lot's of people love it. They need this medication. Perhaps in that rare individual or certain people like myself, or dangergirl it will spark off mild mania. And in rare cases, it causes acute mania. Perhaps there is a need to look into why it is being triggered, and to prescribe more cautiously.

As my doctor said, often when a new drug is on the market it is often seen as panacea, and they prescribe it freely, until unseen side effects start popping up (like in the case of Zyprexa- diabetes- people are suing over that- though it is a very effective drug).

Here is the extract

[verti_goat]

I know that sounds strange, but i have heard from a few people that they went manic; my pdoc thinks I'm manic too now.

CL any crazymed can potentially make any of us crazies manic. Depakote, which you mention going back to, made me manic as hell to the point that I broke my hand punching a rock (the rock won that battle). Celexa also made me manic. But what made me manic could be your life saver, of course.

I did a quick search of the PI sheet and didn't find a mention of mania being a significant side effect.

I wonder if this is because it is not approved for treating bipolar disorder? Topamax is only FDA approved for treating seizures and migraines. For me, Topa has worked great thus far at elimating my migraines; haven't had one in three weeks. And not having a migraine is good for my mood. Can't say that it's doing much for my bp as I'm on other meds as well.

Most PI sheets for crazymeds say that they don't really know exactly how these drugs work. The fact that they do work and help some people is great. The fact that they don't work for everyone is not terribly surprising.

[CrazyLee]

Funny thing my pdoc said to me, "it's a mood stabilizer it can't make you manic"

[verti_goat]

Funny thing my pdoc said to me, "it's a mood stabilizer it can't make you manic"

That is almost funny, except when you're freakin manic on the temporal lobe anti-convulsant and migraine prophylactic he prescribed for you. Sounds like a new pdoc could be in order....

[CrazyLee]

That is almost funny, except when you're freakin manic on the temporal lobe anti-convulsant and migraine prophylactic he prescribed for you. Sounds like a new pdoc could be in order....

well it was only mildly- it seems to be passing for now... my anxiety has gone down on the med tremendously- I am refusing the stimulants she has offered me. And she not he- has several patients on the med, or another AC, and Stimulant combo.

She pretty much said I am socially phobic (getting much better though), and has not closed the door on bipolar, or ADD. So I am neither 1, 2, nor NOS. Then she asked if I just wanted to try an AC+ stimulant combo- I turned it down- although I was having some significant issues with agitation with sitting still in a public setting especially with people. I had major agitation issues on AD's, and in sitting with people. Weirdo insane thing I got. I was so hyper for a while. I'd exercise alot too- practically wore myself into the ground. I am actually slowing a little now. I've seen her on and off for about 4 months now.

I am giving psychiatry a good college try, but sometimes I think it's as good as a witch doctor. Really who is sane?

I often think too if your situation sucks change your situation first, and if it still sucks then add meds. Nothing worse than painting the turds to try and make something better.

[crazynotstupid]

I don't drink much. I would like to drink but I get drunk easily, and I would hate to see how shit faced I would get while medicated.

I actually originally got put on topa because my tdoc told me to go to my gp to get on a mood stabilizer. SO my gp took a look at what i told him, went and looked at his PDR or computer or whatever, and decided on topa because A) it's used as a mood stabilizer and B) it's also used (and at the time, 3 years ago, was I guess kinda being pushed for) to help with drinking issues. I believe the studies have shown quite a nice success rate.

For me, at a proper dosage (400 mg) I turn from a drinking fiend (12 pack to 18 pack a day or so) to like a social drinker--i can like MAX out at 4--toatally pushing it to the limit.

While it is a truism that everyone is different and the mileage will always vary--topamax is about the last med one would expect to get drunker on. (Not that I'm recommending drinking on it, just saying...)

[CrazyLee]

i can like MAX out at 4

yeah and sometimes the word finding stuff I have on this, it would be just funny watching me trying to talk after a drink.

[SashaSue]

Um... so you're on Topamax for social phobia? Really? Or am I missing something here?

[CrazyLee]

I guess- I am not even sure Sasha- My doc I think is just confused about what to do with me. We are still undecided about a lot of the dx- this is what she has told me.

[CrazyLee]

it is working despite some fun times with some hyper euphoric mania that came out of nowhere. It didn't cause me to get fired. That's all I can say.

[CrazyLee]

my doc has offered meds like- seroquel, navane (for the love of god!), effexor, Concerta+mood stabilizer combo, and topamax. The one dx- social phobia.

The door is open on bipolar and ADD. Maybe it's because I am in Canada we can get away with this stuff, we don't have to prove anything to insurance companies.

[SashaSue]

I'm just surprised, because I've never heard of topamax - or any AC's, for that matter - being used to treat social phobia.

[CrazyLee]

Well to be honest, I think my doc finds me a puzzle. I think she thinks the social phobia is a predominant feature, but to a bigger problem (perhaps bp). I had been on a mood stabilizer in the past while in a bad state, which had worked well (but of course the docs messed up royally there, and no one will buy the dx now so I'm back at square one). We know AD's alone aren't so great for me. We can just medicate for social phobia, but I have had clear mood states in the past as well before the phobia.