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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 29. This is the beginning of the thread.
Posted by Beckett on August 16, 2012, at 14:48:32
In an attempt to deal with my anxiety w/o raising my Xanax or benzo load, my pdoc is increasing my topiramate from 100mg daily to 200mg daily. I am to watch for the usual dopamx signs and should expect any results (if any) by next week.
Has anyone heard of topiramate used this way?
Posted by phidippus on August 16, 2012, at 22:09:30
In reply to Can topiramate help anxiety?, posted by Beckett on August 16, 2012, at 14:48:32
Topomax is a potent glutamate antagonist. Increased glutamate is implicated in anxiety-Topomax decreases the glutamate.
Some studies have shown Topomax is effective in treating social anxiety and OCD.
How else do you treat your anxiety?
Eric
Posted by Phillipa on August 16, 2012, at 22:45:31
In reply to Re: Can topiramate help anxiety? » Beckett, posted by phidippus on August 16, 2012, at 22:09:30
I didn't see this on the official drug site? Phillipa
Posted by phidippus on August 16, 2012, at 23:01:29
In reply to Re: Can topiramate help anxiety? » phidippus, posted by Phillipa on August 16, 2012, at 22:45:31
Didn't see what?
Eric
Posted by SLS on August 17, 2012, at 9:42:27
In reply to Re: Can topiramate help anxiety? » Beckett, posted by phidippus on August 16, 2012, at 22:09:30
> Some studies have shown Topomax is effective in treating social anxiety and OCD.
Also, PTSD.
- Scott
Posted by Phillipa on August 17, 2012, at 10:10:22
In reply to Re: Can topiramate help anxiety? » Phillipa, posted by phidippus on August 16, 2012, at 23:01:29
That topiramate is helpful in anxiety. It was listed as one of the side effects. I looked at the official drug monogram site. Are there off label uses? Phillipa
Posted by Phillipa on August 17, 2012, at 10:17:25
In reply to Re: Can topiramate help anxiety? » phidippus, posted by Phillipa on August 17, 2012, at 10:10:22
Seems it's under study for these conditions. First hit so no idea if reliable site. Phillipa
Posted by Beckett on August 17, 2012, at 10:20:14
In reply to Re: Can topiramate help anxiety? » Beckett, posted by phidippus on August 16, 2012, at 22:09:30
>Topomax is a potent glutamate antagonist. Increased glutamate is implicated in anxiety-Topomax decreases the glutamate.
Thank you for the information Eric. It gives me some hope. Beyond 1 to 1.5 mg Xanax daily and some stationary bike riding I have nothing else to treat the anxiety. I'm trying to keep it simple. So many meds seem not to work well for me :(
Posted by Beckett on August 17, 2012, at 10:27:24
In reply to Re: Can topiramate help anxiety?, posted by SLS on August 17, 2012, at 9:42:27
> Also, PTSD.
>
>
> - ScottWell, that would be great if true in my case. Thanks, Scott.
Posted by Beckett on August 17, 2012, at 10:28:40
In reply to Re: Can topiramate help anxiety?, posted by Phillipa on August 17, 2012, at 10:17:25
Thank you for the links Phillipa.
Posted by phidippus on August 17, 2012, at 16:17:28
In reply to Re: Can topiramate help anxiety? » phidippus, posted by Beckett on August 17, 2012, at 10:20:14
Might I recommend Viibryd. Its an SSRI with the added benefit of being a 5ht1a partial agonist. Agonize 5ht1a receptors and you get a great decrease in anxiety and depression. Buspar also has the saame mechanism.
Eric
Posted by phidippus on August 17, 2012, at 16:19:12
In reply to Re: Can topiramate help anxiety? » phidippus, posted by Phillipa on August 17, 2012, at 10:10:22
Plenty of off-label uses: PTSD, OCD, GAD, SA, etc.
Eric
Posted by phidippus on August 17, 2012, at 16:28:29
In reply to Re: Can topiramate help anxiety?, posted by SLS on August 17, 2012, at 9:42:27
I think its obvious you're a bipolar 2.
Eric
Posted by Beckett on August 17, 2012, at 18:31:32
In reply to Re: Can topiramate help anxiety? » Beckett, posted by phidippus on August 17, 2012, at 16:17:28
> Might I recommend Viibryd. Its an SSRI with the added benefit of being a 5ht1a partial agonist. Agonize 5ht1a receptors and you get a great decrease in anxiety and depression. Buspar also has the saame mechanism.
>
> EricI'm hoping to avoid ssri's. They don't seem to help as much as harm later on with side effects. Right now I am taking 5-htp and St. John's wort. Do you think that could possibly be enough...? I am bipolar of some sort and need to stay stable.
Posted by phidippus on August 17, 2012, at 18:35:58
In reply to Re: Can topiramate help anxiety? » phidippus, posted by Beckett on August 17, 2012, at 18:31:32
5htp and St. John's are weak in comparison with an SSRI. But if they're working for you, more power to you.
What sort of side effects have you experienced with SSRIs?
Eric
Posted by Beckett on August 17, 2012, at 18:44:23
In reply to Re: Can topiramate help anxiety? » Beckett, posted by phidippus on August 17, 2012, at 18:35:58
Ssri's tend to destabilize my mood on a daily basis. Mini cycles. I get more fuzzy and fatigued. Numbed, too. Bad with my budget as well. I just don't feel as well in general. Even my shrink acknowledges that ssri's are no great fix for me, hence the move with topomax. Yet the anxiety that can descend is crippling, too. Out of the blue this dread started a few weeks ago. I have only been on the aminos and the st john's wort a scant two weeks. I am really hoping to pull through.
Posted by Beckett on August 17, 2012, at 18:49:06
In reply to Re: Can topiramate help anxiety? » Beckett, posted by phidippus on August 17, 2012, at 16:17:28
> Might I recommend Viibryd. Its an SSRI with the added benefit of being a 5ht1a partial agonist. Agonize 5ht1a receptors and you get a great decrease in anxiety and depression. Buspar also has the saame mechanism.
>
> EricEric, if it comes to it, I will discuss Viibryd with him. Thank you for the suggestion.
Posted by Phillipa on August 17, 2012, at 20:16:58
In reply to Re: Can topiramate help anxiety? » phidippus, posted by Beckett on August 17, 2012, at 18:44:23
Beckett are you saying anxiety was gone and then returned? What changed in life? Phillipa
Posted by Beckett on August 17, 2012, at 21:30:19
In reply to Re: Can topiramate help anxiety? » Beckett, posted by Phillipa on August 17, 2012, at 20:16:58
Hi Phillipa, I have an anxiety disorder along with other issues. Sometimes I don't understand why I have a bad flare. I cannot handle the stress the average person can.
Posted by phidippus on August 18, 2012, at 0:01:05
In reply to Re: Can topiramate help anxiety? » phidippus, posted by Beckett on August 17, 2012, at 18:44:23
I can relate. I am bipolar with OCD. Dread is something I truly understand. Sorry the SSRIs haven't been helpful for you-they can really be effective anxiolytics.
Anyway, I just wanted to share some medications that have helped me in the past with anxiety:
Lyrica
Clonazepam
Gabitril
Prazosin
Keppra
Mirtazapine
Clomipramine
Seroquel
ViibrydRight now I'm on Lithium, Viibryd, Abilify, Clonazepam and I've never felt better. I sincerely hope you find something that works for you-I understand anxiety can be an awful thing.
Eric
Posted by SLS on August 18, 2012, at 6:20:25
In reply to Re: Can topiramate help anxiety? » Phillipa, posted by Beckett on August 17, 2012, at 21:30:19
> Hi Phillipa, I have an anxiety disorder along with other issues. Sometimes I don't understand why I have a bad flare. I cannot handle the stress the average person can.
Have you tried Buspar (buspirone)? It works well for some people to treat chronic anxiety. There is more often than not a delay in the appearance of a therapeutic effect. It can take 1 - 3 weeks to work - just like an antidepressant. Buspar acts as a partial agonist of 5-HT1a receptors, as does Viibryd. However, it also blocks D2 receptors like a mild antipsychotic. Buspar does not inhibit the reuptake of serotonin.Most people don't regard Phenergan (promethazine) as being an anxiolytic, but I saw it work better for anxiety than did Zyprexa for someone with schizoaffective disorder. The Zyprexa had been working pretty well, but the weight gain was unacceptable. I was pleasantly surprised to see him respond so completely to Phenergan.
I wonder if Rhodiola Rosea would be at all helpful. I see a few people report that they respond to it and glean improvements in anxiety, depression, and cognitive impairments. Unfortunately, I see that it is not immune to pooping-out.
Topiramate can effectively treat mixed-states in bipolar II disorder. I have seen it begin working for someone at a dosage of 200 mg/day. It completely abolished the dysphoria, irritability, and rage. This same person was then maintained quite well at a dosage of 100 mg/day. I actually gained a small amount of motivation and energy from topiramate the first time I tried it. However, it most recently was depressogenic for me when added to the other drugs I am currently taking. I think the development of kidney stones is dosage-dependent, so there are good reasons for starting at a low dosage and moving up slowly. Starting at 25 mg and increasing by 25 mg each week is a prudent pace to help prevent cognitive issues. One can use the starter-pack available that is used for treating migranes.
- Scott
Posted by SLS on August 18, 2012, at 6:25:47
In reply to Re: Can topiramate help anxiety? » Beckett, posted by phidippus on August 18, 2012, at 0:01:05
> Right now I'm on Lithium, Viibryd, Abilify, Clonazepam and I've never felt better.
That's great! Totally megacool. I didn't know you were doing so well.
What illnesses are you treating? Is there any bipolarity involved?
- Scott
Posted by Beckett on August 18, 2012, at 10:50:16
In reply to Re: Can topiramate help anxiety? » phidippus, posted by SLS on August 18, 2012, at 6:25:47
Eric and Scott, thank you both for the information. I'm on day three of 200 mg topiramate. My stomache still hurts, but not as much. It just might work, and if not, I have some reccomendations here.
Posted by phidippus on August 18, 2012, at 18:21:18
In reply to Re: Can topiramate help anxiety? » phidippus, posted by SLS on August 18, 2012, at 6:25:47
I'm bipolar 1, with OCD.
Eric
Posted by Phillipa on August 18, 2012, at 19:31:09
In reply to Re: Can topiramate help anxiety? » Phillipa, posted by Beckett on August 17, 2012, at 21:30:19
Same here burned out last summer and can't seem to get back up so to speak. Phillipa
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