Posted by SLS on June 3, 2015, at 17:09:39
In reply to Topiramate sucess stories anyone?, posted by former poster on June 3, 2015, at 9:54:26
> My Pdoc put me on 100mg X3 daily for anxiety and insomnia.
That is a high dosage, particularly for a mood disorder. It is an extremely high dosage to initiate treatment with. You are most likely to develop cognitive and memory impairments unless you titrate gradually. I don't know why your doctor didn't start you off with 25 mg/day. The more gradually you titrate topiramate, the less likely you are to end up with cognitive impairments for the long-term.
I see no reason to go higher than 200 mg/day for topiramate. I have seen it help for hypomanic mixed-state and depression at 100 mg/day can work well for hypomania. 200 mg/day makes a good target. If you respond to that, you can try to reduce the dosage and see if you retain the therapeutic benefit at 100 mg/day. The risk of developing kidney stones (carbonic anhydrase inhibition) is dosage-dependent, so it is best to find the lowest effective dosage early in treatment.
I don't think that you should pass judgement on topiramate yet. However, I wouldn't take any more until you develop a plan to titrate the dosage properly. I would start at 25 mg/day. You could then go to 50 mg/day for a week and then to 100 mg/day. I actually went slower than this. At 200 mg/day, I didn't have the slightest worsening of cognitive and memory deficits.
http://www.ncbi.nlm.nih.gov/pubmed/11215835
At least follow the drug company's guidelines.
" Post-marketing data from physicians with clinical experience with TOPAMAX
have shown that slower titration improves tolerability and may reduce the rate
of discontinuation due to a lessening of side effects. The new dosing
schedule recommends that TOPAMAX be administered initially at 25-50 mg per
day, and titrated in increments of 25-50 mg per week until an effective daily
dose is reached.
"
- Scott
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:1079389
URL: http://www.dr-bob.org/babble/20150520/msgs/1079406.html