Posted by SLS on February 20, 2012, at 18:32:48
In reply to re: Desperate - Part 2 - Please no anti-med posts, posted by Solstice on February 20, 2012, at 16:06:19
Well, anyway, Topamax is a drug that I have seen treat successfully bipolar II dysphoric hypomania in a 40 year old woman. She was first treated with 200 mg, but it was subsequently found that 100 mg was just as effective, and reduced the risk of developing kidney stones.
The clinical trials of Topamax to evaluate its efficacy in treating mania have not produced impressive results. I would not make Topamax my first choice as a treatment for pediatric bipolar disorder. However, there are anecdotes that report success with its use. Depakote would be a better choice if one is to explore anticonvulsant mood-stabilizers. My main concerns with Depakote are that the dosage of Lamictal must be reduced and that it might leave your daughter somewhat depressed with continued use.
In any event, I still feel that Topamax is a viable treatment that can yield improvements in mania in bipolar disorder.
- Scott
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Topiramate as add-on treatment for patients with bipolar mania.Chengappa KN, Rathore D, Levine J, Atzert R, Solai L, Parepally H, Levin H, Moffa N, Delaney J, Brar JS.
Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, PA 15215-2593, USA. chengappakn@msx.upmc.edu
Abstract
OBJECTIVE:
Anticonvulsant agents such as carbamazepine and valproate are alternatives to lithium in treating subjects with bipolar disorder. Topiramate (Topamax), a new antiepileptic agent, is a candidate drug for bipolar disorder. We evaluated topiramate as adjunctive treatment for bipolar patients.
METHODS:
Eighteen patients with DSM-IV bipolar I disorder [mania (n = 12), hypomania (n = 1), mixed episode (n = 5), and rapid cycling (n = 6)], and two subjects with schizoaffective disorder bipolar type, resistant to current mood-stabilizer treatment were initiated on topiramate, 25 mg/day, increasing by 25-50 mg every 3 7 days to a target dose between 100 and 300 mg/day, as other medications were held constant for 5 weeks. The Young Mania Rating Scale (Y-MRS), Hamilton Depression Rating Scale (Ham-D), and Clinical Global Impression-Bipolar Version Scale (CGI-BP) were used to rate subjects weekly.
RESULTS:
By 5 weeks, 12 (60%) subjects were responders, i.e., 50% reduction in the Y-MRS scores and a CGI of 'much' or 'very much improved'. Three subjects were 'minimally improved', four showed no change, and one was 'minimally worse'. Six subjects had parasthesia, three experienced fatigue, and two had 'word-finding' difficulties; in all cases, side effects were transient. All patients lost weight with a mean of 9.4 lb in 5 weeks, and a significant reduction in body mass index (BMI) occurred too.
CONCLUSIONS:
Topiramate appears to have efficacy for the manic and mixed phases of bipolar illness. Other preliminary data suggest antidepressant efficacy too. Among obese bipolar subjects, the weight loss potential of topiramate may be beneficial. If controlled trials confirm these initial results, topiramate may be a significant addition to the available treatments for bipolar disorder.
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Some see things as they are and ask why.
I dream of things that never were and ask why not.- George Bernard Shaw
poster:SLS
thread:1010739
URL: http://www.dr-bob.org/babble/20120212/msgs/1011028.html