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I'm intersted in Topamax as a possible med for me. I have two questions about it, though:

Is it effective w/lithium or better on its own?

Everyone talks about weight loss---why do people lose weight while on topamax?


First of all, why are you wanting to take Topamax? Are you on lithium now? What are you taking it for?

To answer your question though, Lithium doesn't appear to have any real effect on Topamax that I know of, but Topamax can affect Lithium's serum levels. So you will have to monitor that carefully if you intoduce Topamax and you are already taking Lithium.

As to weight loss...it's a side effect that some people get and some don't. If that's the primary reason you are wanting the med then just be warned: if you don't have a temporal lobe issue or other problem that Topamax hits it can make you more stupid than Britney Spears on her worst day, and worst of all you may never get the weight loss that you are seeking.

If you want more info you can read up on it here.

Good luck.

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Topamax is, like, way different from lith. they act on the brain...well, differently. Different receptors basically--I don't know all the particulars. ,lobes and sodium voltage channels and stuff.

Big thing I have to say is: if you take them together, topamax will increase the serum level of lithium you have--by about 20%, usually. I wouldn't recommend taking them together, but if you were to do so, REALLY keep that in mind. It's gonna make you change your lith dose.

As to the weight loss thing--who reallt knows? I don't think they've reallt pinned that one down yet.

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In theory, they're OK together, although, as CNS writes, lithium serum levels can vary. (My LiSL didn't vary, and, for assorted reasons, I was checking every day or every other day, along with the topiramate SL.)

In practice, the cognitive effects are additive. Topamax is a CAI and this has renal implications (including the much-touted stones), and I hear enough about problems with the two together that I would be careful. I wouldn't put the combo on the verboten list, but I'd monitor renal function and LiSL pretty damn closely.

I'm off both due to nephrogenic diabetes insipidus, although we're doing a cautious trial of lithium again with HCTZ and Celebrex. What with the crazy and all. Ahem. Turns out stopping my lithium abruptly tends to do bad things. Nephro says it'll be one or the other for me but not both. Which sucks. Because I need both. Very different drugs, very different actions. It's not like comparing apples and oranges, more like apples and Dalmatians.

As to the weight loss, hell, I lose weight on lithium but not on topiramate, so I'm the poster girl for YMMV.

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