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Re: Alternative to Depakote

Posted by Theresa on February 11, 1999, at 21:40:32

In reply to Re: Alternative to Depakote, posted by Elizabeth on February 10, 1999, at 17:00:42

Dear Elizabeth -- you are correct that Tegretol was never approved for bipolar disorder. It's used so often for that indication, though, that it's hard to remember that. As for Topamax causing weight loss, that's only based on one small study that I know of (Dr. Susan McElroy, Cincinnati). I think the APA meeting will have a lot more data presented on Topamax for bipolar disorder that may clear that up.

It's a shame that so many of these agents for bipolar disorder cause weight gain, because I think a lot of people get off them for that reason and then aren't stabilized. Someday perhaps we'll have a targeted drug just for bipolar disorder (not approved for other indications) other than lithium! Wouldn't that be wonderful! (Drug companies, are you listening?) Theresa

> > There are other anticonvulsants that you can try that may not cause weight gain. They include carbamazapine (Tegretol), lamotrigine (Lamictal), gabapentin (Neurontin), and topiramate (Topamax). The last three are relatively new anticonvulsants and haven't been approved for bipolar disorder or other psychiatric disorders, but they are being widely studied for those indications. Topamax in particular does not seem to cause weight gain. New data should be presented at the upcoming American Psychiatric Association meeting this May. Ask your psychiatrist to contact APA and he/she should be able to get the abstracts from the meeting. The APA's number is 202-682-6000.
>
> Tegretol actually was never approved for bipolar disorder either!
>
> I know that at least some people *lose* weight on Topamax. I don't know what the clinical experience with it has been like so far, though. A lot of people gain weight on Depakote and lithium, and some seem to on Neurontin too. Don't think I've heard of anyone gaining weight from Lamictal.


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