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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by bipolarspectrum on June 2, 2005, at 14:38:44
Hi,
I finally got my pdoc to put me on topamax with olanzapine... I'm praying its going to have antidepressant qualities.. anywayz, good luck to all my fellow babblers.. ill keep u updated..
bps
Posted by Maxime on June 2, 2005, at 19:36:48
In reply to Starting TOPAMAX! Plz let it be an antidepressant!, posted by bipolarspectrum on June 2, 2005, at 14:38:44
> Hi,
> I finally got my pdoc to put me on topamax with olanzapine... I'm praying its going to have antidepressant qualities.. anywayz, good luck to all my fellow babblers.. ill keep u updated..
> bpsUm, it doesn't, sad to say. But who knows why type of effect you get by combining it with Zyprexa! I hope it helps.
Maxime
Posted by bipolarspectrum on June 2, 2005, at 19:40:57
In reply to Re: Starting TOPAMAX! Plz let it be an antidepress » bipolarspectrum, posted by Maxime on June 2, 2005, at 19:36:48
Hi Maxime,
My pdoc is one of the guys whos invovled with the DBS in Toronto.. he was tellin me that he just completed a study with 75 bipolar patients and topamax helped their bipolar depression... theres another canadian study where its compared to bupropion.. and both topamax and wellbutrin prove to be effective for bipolar depression...
so im keepin my fingers crossed!
bps
Posted by Maxime on June 2, 2005, at 22:00:49
In reply to New study shows it does!, posted by bipolarspectrum on June 2, 2005, at 19:40:57
Really? Topomax is effective for bipolar depression but as a mood stabiliser and not as an antidepressant. It has no antidepressant propertities.
I'll keep my fingers crossed for you too!
Maxime
> Hi Maxime,
> My pdoc is one of the guys whos invovled with the DBS in Toronto.. he was tellin me that he just completed a study with 75 bipolar patients and topamax helped their bipolar depression... theres another canadian study where its compared to bupropion.. and both topamax and wellbutrin prove to be effective for bipolar depression...
> so im keepin my fingers crossed!
> bps
Posted by Nickengland on June 3, 2005, at 4:53:37
In reply to Re: New study shows it does! » bipolarspectrum, posted by Maxime on June 2, 2005, at 22:00:49
I was looking at this the other day... Heres the study..
Topiramate versus bupropion SR when added to mood stabilizer therapy for the depressive phase of bipolar disorder: a preliminary single-blind study.
McIntyre RS, Mancini DA, McCann S, Srinivasan J, Sagman D, Kennedy SH.
Department of Psychiatry, University of Toronto, Mood and Anxiety Disorders Program, Center for Addiction and Mental Health, Clarke Site, Ontario, Canada. roger_mcintyre@camh.net
OBJECTIVE: Antiepileptic drugs (AEDs) are commonly employed in the treatment of bipolar disorder. The efficacy and tolerability of topiramate, a novel anticonvulsant, and bupropion SR when added to mood stabilizer therapy were compared under single-blind conditions (rater-blinded) in patients meeting DSM-IV criteria for bipolar I/II depression. METHODS: A total of 36 out-patients with Hamilton Depression Rating Scale (HDRS-17) scores > or = 16 were randomized to receive escalating doses of either topiramate (50-300 mg/day) or bupropion SR (100-400 mg/day) for 8 weeks. Data were analyzed on an intent-to-treat basis using the last observation carried forward method. RESULTS: The percentage of patients meeting a priori response criteria (> or = 50% decrease from baseline in mean HDRS-17 total score) was significant for both topiramate (56%) and bupropion SR (59%) [t(17) = 2.542, p = 0.04 and t(17) = 2.661, p = 0.03, respectively]. Baseline demographic and clinical parameters were comparable between the two treatment groups. The mean doses of study medication were 176 mg/day (SD = 102 mg/day) for the topiramate-treated group and 250 mg/day (SD = 133 mg/day) for the bupropion SR-treated group. A significant and comparable reduction in depressive symptoms was observed from baseline to endpoint following topiramate and bupropion SR treatment, according to a > or = 50% reduction in the HDRS-17. Total mean HDRS-17 scores significantly decreased from baseline to endpoint in both groups (p = 0.001), however, differences between the topiramate-treated group and the bupropion SR-treated group were not significant [t(36) = 1.754, p = 0.097]. Both topiramate and bupropion SR were generally well tolerated. Thirteen patients discontinued the study: 2 because of lack of efficacy, 1 due to withdrawal of consent and 10 following side-effects (six in the topiramate and four in the bupropion SR-treated group). There were no cases of affective switch in either arm. Weight loss was experienced by patients in both groups (mean weight loss at endpoint was 1.2 kg in bupropion SR and 5.8 kg in topiramate) [t(17) = 2.325, p = 0.061 and t(17) = 2.481, p = 0.043, respectively]. CONCLUSIONS: These preliminary data suggest that adjunctive topiramate may reduce depressive symptom severity in acute bipolar depression. The antidepressant efficacy of this compound requires confirmation via double-blind placebo controlled investigation.
Posted by SLS on June 3, 2005, at 7:14:44
In reply to Re: New study shows it does! » Maxime, posted by Nickengland on June 3, 2005, at 4:53:37
> I was looking at this the other day... Heres the study..
> The efficacy and tolerability of topiramate, a novel anticonvulsant, and bupropion SR when added to mood stabilizer...
I'd be interested to know which mood stabilizers were used in combination with topiramate. Maybe I should place topiramate higher up on my list of things to try.
- Scott
Posted by bipolarspectrum on June 3, 2005, at 13:19:03
In reply to Re: New study shows it does!, posted by SLS on June 3, 2005, at 7:14:44
Hey SLS,
You've always been very helpful to me... I think you and I both suffer from a bipolar spectrum disorder (just my opinion).. theres a great review written by stephen stahl which discusses how bipolar spectrum individuals require 2/3 drugs in combination... good luck
bps
Posted by SLS on June 3, 2005, at 14:08:32
In reply to SLS, posted by bipolarspectrum on June 3, 2005, at 13:19:03
> Hey SLS,
> You've always been very helpful to me... I think you and I both suffer from a bipolar spectrum disorder (just my opinion).. theres a great review written by stephen stahl which discusses how bipolar spectrum individuals require 2/3 drugs in combination... good luck
> bps
Thanks, BPS.Where can I find this work?
This is what I'm currently taking:
Lamictal 150mg
nortriptyline 100mg
Parnate 80mg
Abilify 10mgI'm still playing with Trileptal.
- Scott
Posted by Maxime on June 3, 2005, at 15:18:50
In reply to Re: New study shows it does! » Maxime, posted by Nickengland on June 3, 2005, at 4:53:37
Wow, thank you Nick for that article. I learned something new today thanks to you! Cheers!
Maxime
> I was looking at this the other day... Heres the study..
>
> Topiramate versus bupropion SR when added to mood stabilizer therapy for the depressive phase of bipolar disorder: a preliminary single-blind study.
>
> McIntyre RS, Mancini DA, McCann S, Srinivasan J, Sagman D, Kennedy SH.
>
> Department of Psychiatry, University of Toronto, Mood and Anxiety Disorders Program, Center for Addiction and Mental Health, Clarke Site, Ontario, Canada. roger_mcintyre@camh.net
>
> OBJECTIVE: Antiepileptic drugs (AEDs) are commonly employed in the treatment of bipolar disorder. The efficacy and tolerability of topiramate, a novel anticonvulsant, and bupropion SR when added to mood stabilizer therapy were compared under single-blind conditions (rater-blinded) in patients meeting DSM-IV criteria for bipolar I/II depression. METHODS: A total of 36 out-patients with Hamilton Depression Rating Scale (HDRS-17) scores > or = 16 were randomized to receive escalating doses of either topiramate (50-300 mg/day) or bupropion SR (100-400 mg/day) for 8 weeks. Data were analyzed on an intent-to-treat basis using the last observation carried forward method. RESULTS: The percentage of patients meeting a priori response criteria (> or = 50% decrease from baseline in mean HDRS-17 total score) was significant for both topiramate (56%) and bupropion SR (59%) [t(17) = 2.542, p = 0.04 and t(17) = 2.661, p = 0.03, respectively]. Baseline demographic and clinical parameters were comparable between the two treatment groups. The mean doses of study medication were 176 mg/day (SD = 102 mg/day) for the topiramate-treated group and 250 mg/day (SD = 133 mg/day) for the bupropion SR-treated group. A significant and comparable reduction in depressive symptoms was observed from baseline to endpoint following topiramate and bupropion SR treatment, according to a > or = 50% reduction in the HDRS-17. Total mean HDRS-17 scores significantly decreased from baseline to endpoint in both groups (p = 0.001), however, differences between the topiramate-treated group and the bupropion SR-treated group were not significant [t(36) = 1.754, p = 0.097]. Both topiramate and bupropion SR were generally well tolerated. Thirteen patients discontinued the study: 2 because of lack of efficacy, 1 due to withdrawal of consent and 10 following side-effects (six in the topiramate and four in the bupropion SR-treated group). There were no cases of affective switch in either arm. Weight loss was experienced by patients in both groups (mean weight loss at endpoint was 1.2 kg in bupropion SR and 5.8 kg in topiramate) [t(17) = 2.325, p = 0.061 and t(17) = 2.481, p = 0.043, respectively]. CONCLUSIONS: These preliminary data suggest that adjunctive topiramate may reduce depressive symptom severity in acute bipolar depression. The antidepressant efficacy of this compound requires confirmation via double-blind placebo controlled investigation.
>
Posted by Nickengland on June 3, 2005, at 16:10:59
In reply to Re: New study shows it does! » Nickengland, posted by Maxime on June 3, 2005, at 15:18:50
I always mostly skip to just read the conclusion part of the study LOL
Kind regards
Nick :-)
Posted by bipolarspectrum on June 3, 2005, at 16:44:50
In reply to Re: SLS ... Thanks! » bipolarspectrum, posted by SLS on June 3, 2005, at 14:08:32
J Clin Psychiatry. 2004 Oct;65(10):1298-9. Related Articles, Links
Drug combinations for bipolar spectrum disorders: evidence-based prescribing or prescribing-based evidence?Stahl SM.
Neuroscience Education Institute in Carlsbad, Calif. 92009, USA.
Are u able to access such articles??
bps
Posted by SLS on June 3, 2005, at 20:28:32
In reply to Re: SLS ... Thanks!, posted by bipolarspectrum on June 3, 2005, at 16:44:50
Hi BPS.
> J Clin Psychiatry. 2004 Oct;65(10):1298-9. Related Articles, Links
>
>
> Drug combinations for bipolar spectrum disorders: evidence-based prescribing or prescribing-based evidence?
>
> Stahl SM.
>
> Neuroscience Education Institute in Carlsbad, Calif. 92009, USA.
>
> Are u able to access such articles??
> bps
I haven't been in a library in over 10 years. Before the age of the Internet and Medline, I spent time at the Rutgers medical school library. If it ain't on the Net, and it ain't for free, I have no access to it.That article title is typical Stahl. Every now and then, I think about going out to buy one of his "Essential" books, but I keep worrying that he'll release an updated version the day after I pay for the old one. :-)
- Scott
Posted by SLS on June 3, 2005, at 20:36:44
In reply to Re: SLS ... Thanks!, posted by bipolarspectrum on June 3, 2005, at 16:44:50
I found it:
http://www.psychiatrist.com/brainstorms/br6510.pdf
I had read this already. Stahl is quite a character.
- Scott
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