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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by porkpiehat on July 22, 2019, at 14:39:26
My doc wants me to try topomax (after I asked him to research it for mood stabilization and borderline traits). I am very worried about cognitive effect and sleep.
Currently taking 10mg celexa and 100mg Lamictal. I think both Lamictal and topomax are heavy glutamate blockers, so I wonder if I'd have an increased risk of the stupids.
Does anyone have experiences they could please share?
Posted by linkadge on July 22, 2019, at 15:29:40
In reply to anyone try topomax topiramate?, posted by porkpiehat on July 22, 2019, at 14:39:26
Adding a 2nd anti-epileptic medication could cause additive effects on cognition. I suppose a higher dose of lamotrigine wouldn't be effective? Lamotrigine generally has fewer cognitive effects, as compared with topomax.
Linkadge
Posted by porkpiehat on July 22, 2019, at 15:36:50
In reply to Re: anyone try topomax topiramate?, posted by linkadge on July 22, 2019, at 15:29:40
> Adding a 2nd anti-epileptic medication could cause additive effects on cognition. I suppose a higher dose of lamotrigine wouldn't be effective? Lamotrigine generally has fewer cognitive effects, as compared with topomax.
>
>
> LinkadgeI respond quite poorly to higher doses of lamictal, esp. cognitive problems, sleep issues, obsessive anxieties, headaches, muscle spasms, ocasional mixed episodes
Unfortunately they seem worse with my SSRI, but I need the two to handle both the anxiety and depression.
I was half hoping I would need to take way less topomax because I'm on Lamictal already.
Posted by linkadge on July 22, 2019, at 19:06:45
In reply to Re: anyone try topomax topiramate? » linkadge, posted by porkpiehat on July 22, 2019, at 15:36:50
Hey,
With what you mention, there is no harm in trying topomax. It does have a reputation of causing cognitive issues, but you may not have this issue with lower doses.
Linkadge
Posted by rjlockhart37 on July 22, 2019, at 19:19:00
In reply to Re: anyone try topomax topiramate? » porkpiehat, posted by linkadge on July 22, 2019, at 19:06:45
they also use topamax for weight loss, i've read medical reviews that they sometimes prescribe it for weight issues, but topamax i've heard street term called dopamax because it's clouding thinking, but yeah defiently give it a try, they also add it on to lamotragine if it causes lamotragine induced mania, lamitical is mainly mood stablizer for depression, it targets depressive symptoms more than manic, lithium is more for manic symptoms. Sometimes they add it on for extra kick to stablize mood
Posted by PeterMartin on July 23, 2019, at 12:32:03
In reply to Re: anyone try topomax topiramate?, posted by rjlockhart37 on July 22, 2019, at 19:19:00
I don't think you'll like Topamax. You seem to be pretty alert to minor cognitive changes. I've take Topamax on a few occasions to lost weight. It worked the first two times but not most recently. The side effects though are pretty rough. Cognitive effects in particular. Things like doing simple math (for ex: how much do I tip) became extremely difficult. Personally I wouldn't recommend it for mood stabilizing. If your hope is is to lose weight with it start slow and keep the dose low (50-100mg). If it's your first time taking it it'll likely have you dropping lbs.
Posted by porkpiehat on July 23, 2019, at 12:47:43
In reply to Re: anyone try topomax topiramate?, posted by PeterMartin on July 23, 2019, at 12:32:03
PeterMartin, What dosage were you at when you experienced the cognitive issues? Were you taking anything else with the Topomax?
Posted by SLS on July 23, 2019, at 17:03:31
In reply to Re: anyone try topomax topiramate? » PeterMartin, posted by porkpiehat on July 23, 2019, at 12:47:43
> PeterMartin, What dosage were you at when you experienced the cognitive issues? Were you taking anything else with the Topomax?
I had no cognitive side effects with Tomamax at a dosage of 200 mg/day. After several weeks, it didn't help with depression, so I stopped taking it. I saw one person with a hypomanic mixed-state respond well to Topamax monotherapy at 200 mg/day. The dosage was later reduced to 100 mg/day. I'm not sure why.
- Scott
Posted by Lamdage22 on July 24, 2019, at 6:19:46
In reply to Re: anyone try topomax topiramate?, posted by SLS on July 23, 2019, at 17:03:31
Hi Scott,
hope you are well. Did you loes weight on topamax? Is topamax and driving a problem?
Posted by PeterMartin on July 25, 2019, at 9:43:59
In reply to Re: anyone try topomax topiramate? » PeterMartin, posted by porkpiehat on July 23, 2019, at 12:47:43
> PeterMartin, What dosage were you at when you experienced the cognitive issues? Were you taking anything else with the Topomax?
>
>Iirc around 100. Topamax (topiramate) was another med where I found I responded differently to different generics. I wish I could recommend a brand but I never settled on one. It did seem to help my mood at a point (200ish) but honestly that may have been due to not being able to focus too much (ignorance is bliss).
Yea I always take a few things. Lamictal ~200, Nardil 75, Seroquel 25 (sleep), metformin er 2000. Of course those can cause cognitive issues also. Topamax just always felt "dirty" to me.
If you can get brand you may have more success than I did. I was fine on it and it did help me drop 20lbs in 10months or so the first time around (while still taking Marplan/Seroquel). That said, it seems as though you're very sensitive to cognitive changes. I have a fairly simple life so minor memory or ability to do math issues aren't necessarily a deal breaker for me.
Posted by SLS on July 26, 2019, at 10:15:54
In reply to Re: anyone try topomax topiramate?, posted by Lamdage22 on July 24, 2019, at 6:19:46
> Hi Scott,
>
> hope you are well.Thanks. Today is a good day so far - the best I've had in weeks. A few days ago, I reduced my dosage of Trintellex (vortioxetine) from 15 mg/day to 10 mg/day. If I continue to do well, I would be an example of Trintellix having a true dosage window. It is too early to tell.
> Did you loes weight on topamax? Is topamax and driving a problem?
I don't recall losing weight while I was taking Topomax. However, I was taking Abilify at the time. I read awhile ago that the weight loss attributed to Topomax doesn't last. I really don't know.
I didn't experience anything while taking Topomax that interfered with driving.
- Scott
Posted by porkpiehat on August 21, 2019, at 11:37:29
In reply to Re: anyone try topomax topiramate?, posted by SLS on July 26, 2019, at 10:15:54
So I started a topomax trial last week...I have been feeling cyclical bouts of either irritability or self destructive depression, racing negative thoughts (always in the afternoon). It was a friday after work and I figured adverse side effects could be handled over the weekend.
At 25mgs I felt this lability cycle break a little bit; persecuted thoughts slowed down and so did the anger a bit; I felt a little less driven to do irresponsible stuff while felt like tackling (not avoiding) all the stuff around me that needed doing.
BUT...Although I felt a little slow at first getting underway and driving, it wasn't until I had to interact with people verbally that I felt pretty stupid. Couldn't explain what I needed to store associates. My good friend called me and it was the most stilted, unnatural, labored discussion.
The same results occurred throughout the the weekend. I would wake up easier without feelings of dread and avoidance, but upon dealing with people I felt stunted and without confidence, very unable to finish my thoughts.
I also felt pretty tired during the day despite dosing at night
Obviously this is half of the lowest typical dose. "Interpersonal sensitivity" is supposed to improve not worsen on this drug.
For anyone with experience...is it worth going up and risking worsening of this knowing that "dopomax" isn't going to get less dopey with dose increase?
Also taking 100mg Lamictal, 10mgs celexa, nighttime klonopin .25 mgs, and either modafinil or ritalin during the day.
This is the end of the thread.
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