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Why the caution about multiple ACs?


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Guest Llamanator

Two pdocs I've seen have been hesitant about putting me on a 3rd AC (Topamax).

My curiosity is, why the hesitation? I don't have much in the way for side effects for the ones I started with (Lamictal 200mg, Neurontin 900mg), or much in the way of side effects at all. I Can Hold My AEDs.

I managed to convince the new pdoc to put me on Topamax using the "current lack of more than mildly annoying side effects" method.

Is that normally a large concern for people?

Mimi

*who is waiting for the Topamax stupid to kick in*

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Guest Llamanator

Starting at 25mg, going up 25mg every two weeks. Yes, two weeks. I might convince them to go faster if the first couple of increases are uneventful.

I seriously doubt I'll have any major (lasting) problems with it. The docs are far more worried about it than I am. Meh.

If anything, I feel more clear-headed a few hours after the first dose. Maybe it'll happen again, maybe not, we'll see.

I'm just curious as to why the worry about multiple ACs. If they're tolerated, and they work, isn't that what's important?

Mimi

*who feels slower, can concentrate better, part of it's the LACK of racing thoughts*

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Mimi,

I (unfortunately) don't know the answer to your actual question, but don't try to go up any faster than you are currently going.  The slower you go up, the less likely you'll get any niggling side effects (for too long, anyway), and the MORE likely the Topa will work for you long term.

6

(who has been on Topa since early '02 and Lamictal since 12/02 w/ NO problems other than a complete lack 'o nouns)

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(sigh)  Well, I can't imagine there being any real problem with it being three AC's alone--'less someone around here knows something that I simply do not.

Mebbe it's simply that they didn't want to put you on Topamax?  Or they're just afraid of your brain oozing out your ears; I dunno...

Hmmph, between the Neurontin and Topamax (and, well, some talk about brain-dulling with Lamictal) maybe they think your IQ will drop to -38 or something.  Who knows?

Ah, but as for titrations--heh, I did 50 a week, every week up to 200 and then again up to 400.  Hit the stoopid branch a couple times and that was it.

Just finished (tonight even!) titrating down from 400 to 50--started at 400 cutting to 200 for two weeks, then to 100 for three, and now 50.

And dammit, if I ever get money again, I'm hopping the express elevator back up.

Anyways, good going on convincing the docs; glad to see you finally got on the Topa train (it only took you HOW long to find somebody who'd listen, even if it's like this?)

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