![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 134 to 158 of 1085. Go back in thread:
Posted by Sammy on October 8, 2001, at 19:06:22
In reply to Re: Celexa » Sammy, posted by Krazy Kat on September 27, 2001, at 15:56:02
> Krazy Kat
If this gets through, will you please send me your email address so I can get a message through to you? Mine is adssay@aol.com
Thanks!
Sammy
Posted by inky on November 7, 2001, at 14:38:52
In reply to Re: Topamax Experiences?, posted by Janice1 on January 4, 2001, at 18:52:01
Hi,
I just started (last night first dose) on Topomax as a migraine prophylaxis.
I don't have a history of any psychological disorders. just found this site through a Google search and you guys sound really knowledgeable.
I've had migraines for most of my adult life and in the last few months they've become daily occurences. I've been taking Zomig and Ibuprofen to combat attacks -- have tried lots of other meds, too, both preventive and "abortive."
My doctor, a headache specialist, recommended Topomax based on some very favorable results in his other patients.
I'm a bit worried about side effects. They started me on 15 mg/day to increase by 15 mg each week until either the daily migraines go away or I reach 90 mg/day.
I'm not taking any other neurological drugs.
I'm a bit worried about the side effects. I do feel a bit groggy today but I don't know if it's from the Topomax. Is this commmon? Does it go away?
My doctor mentioned tingling fingers, loss of mental acuity, depression, weight loss (not a negative in my opinion!) and dehydration.
Has anyone experienced any of these? I'm particularly worried about the loss of mental acuity and grogginess since I need my brain power! I'm also worried about depression because I've seen what a horrible disease that can be.
And I'd like to know if the side effects tend to go away with time. If so, how long does it take?
If anyone has any advice, comments, experiences, etc. on taking Topomax for migraines, I'd appreciate it.
Thanks!
Posted by Mitch on November 7, 2001, at 23:12:02
In reply to Starting on Topomax for Migraines. Advice anyone?, posted by inky on November 7, 2001, at 14:38:52
> Hi,
>
> I just started (last night first dose) on Topomax as a migraine prophylaxis.
>
> I don't have a history of any psychological disorders. just found this site through a Google search and you guys sound really knowledgeable.
>
> I've had migraines for most of my adult life and in the last few months they've become daily occurences. I've been taking Zomig and Ibuprofen to combat attacks -- have tried lots of other meds, too, both preventive and "abortive."
>
> My doctor, a headache specialist, recommended Topomax based on some very favorable results in his other patients.
>
> I'm a bit worried about side effects. They started me on 15 mg/day to increase by 15 mg each week until either the daily migraines go away or I reach 90 mg/day.
>
> I'm not taking any other neurological drugs.
>
> I'm a bit worried about the side effects. I do feel a bit groggy today but I don't know if it's from the Topomax. Is this commmon? Does it go away?
>
> My doctor mentioned tingling fingers, loss of mental acuity, depression, weight loss (not a negative in my opinion!) and dehydration.
>
> Has anyone experienced any of these? I'm particularly worried about the loss of mental acuity and grogginess since I need my brain power! I'm also worried about depression because I've seen what a horrible disease that can be.
>
> And I'd like to know if the side effects tend to go away with time. If so, how long does it take?
>
> If anyone has any advice, comments, experiences, etc. on taking Topomax for migraines, I'd appreciate it.
>
> Thanks!
Hi Inky,It seems that more anti-epielpsy meds are starting to be used for migraine prophylaxis. I know Depakote has been used for that and has an approvable indication for that purpose.
I have tried Topamax for my bipolar. Lots of others here have tried it as well for various things (mostly bipolar disorder). All I can say is that it *can* cause some fairly bad cognitive dulling effects. I wouldn't say that it is all that "depressogenic". As with many meds nowadays you have to start low and go slow with dose increases. I made it up to 50mg/day for a while with other meds added on and I was pretty foggy-headed. Many people here have had little trouble with that if you hang with a dose long enough before you increase it. 15mg to start was where I started. I would continue taking the 15mg/day dose until the "tiredness" or whatever seems to abate *before* you go up a notch in the dosage FWIW,
Mitch
Posted by mcmud on November 9, 2001, at 11:54:30
In reply to Re: Starting on Topomax for Migraines. Advice anyone? » inky, posted by Mitch on November 7, 2001, at 23:12:02
Hi Inky. I have been taking Topamax for > 6 mos. for phantom pain, in combination w/ amitrip. and hydrocodone. The adage start low, go slow is probably the best advice. I found that 50 mg/day is what I can tolerate without experiencing unacceptable side effects. Tingling of the extremities is common. It is very important to stay well hydrated when taking this drug.
Posted by JohnX2 on November 12, 2001, at 17:41:21
In reply to Re: Starting on Topomax for Migraines. Advice anyone? » inky, posted by Mitch on November 7, 2001, at 23:12:02
Hi,Topomax is one of the few anti-convulsants I have
not tried. I have chronic tension headache and
bruxism and lately was suggested baclofen. But
my older neurologist thouht Topomax may help.
I never got substantial relief from the other
anti-convulsants, but i am currently taking lamictal
and klonopin is the main releaver of my headaches.
When I looked into topomax I saw it worked very
differently than lamictal and it had action at the
GabaA receptor increasing Cl- conductance which is
also what klonopin does. So I was still thinking it
may be good to try, especially given the latest buzz
regarding it being a good adjunct to lamictal.Any thoughts?
Thanks,
john> > Hi,
> >
> > I just started (last night first dose) on Topomax as a migraine prophylaxis.
> >
> > I don't have a history of any psychological disorders. just found this site through a Google search and you guys sound really knowledgeable.
> >
> > I've had migraines for most of my adult life and in the last few months they've become daily occurences. I've been taking Zomig and Ibuprofen to combat attacks -- have tried lots of other meds, too, both preventive and "abortive."
> >
> > My doctor, a headache specialist, recommended Topomax based on some very favorable results in his other patients.
> >
> > I'm a bit worried about side effects. They started me on 15 mg/day to increase by 15 mg each week until either the daily migraines go away or I reach 90 mg/day.
> >
> > I'm not taking any other neurological drugs.
> >
> > I'm a bit worried about the side effects. I do feel a bit groggy today but I don't know if it's from the Topomax. Is this commmon? Does it go away?
> >
> > My doctor mentioned tingling fingers, loss of mental acuity, depression, weight loss (not a negative in my opinion!) and dehydration.
> >
> > Has anyone experienced any of these? I'm particularly worried about the loss of mental acuity and grogginess since I need my brain power! I'm also worried about depression because I've seen what a horrible disease that can be.
> >
> > And I'd like to know if the side effects tend to go away with time. If so, how long does it take?
> >
> > If anyone has any advice, comments, experiences, etc. on taking Topomax for migraines, I'd appreciate it.
> >
> > Thanks!
>
>
> Hi Inky,
>
> It seems that more anti-epielpsy meds are starting to be used for migraine prophylaxis. I know Depakote has been used for that and has an approvable indication for that purpose.
>
> I have tried Topamax for my bipolar. Lots of others here have tried it as well for various things (mostly bipolar disorder). All I can say is that it *can* cause some fairly bad cognitive dulling effects. I wouldn't say that it is all that "depressogenic". As with many meds nowadays you have to start low and go slow with dose increases. I made it up to 50mg/day for a while with other meds added on and I was pretty foggy-headed. Many people here have had little trouble with that if you hang with a dose long enough before you increase it. 15mg to start was where I started. I would continue taking the 15mg/day dose until the "tiredness" or whatever seems to abate *before* you go up a notch in the dosage FWIW,
>
> Mitch
Posted by Mitch on November 12, 2001, at 22:56:23
In reply to Re: Starting on Topomax for Migraines. Advice anyone?, posted by JohnX2 on November 12, 2001, at 17:41:21
>
> Hi,
>
> Topomax is one of the few anti-convulsants I have
> not tried. I have chronic tension headache and
> bruxism and lately was suggested baclofen. But
> my older neurologist thouht Topomax may help.
> I never got substantial relief from the other
> anti-convulsants, but i am currently taking lamictal
> and klonopin is the main releaver of my headaches.
> When I looked into topomax I saw it worked very
> differently than lamictal and it had action at the
> GabaA receptor increasing Cl- conductance which is
> also what klonopin does. So I was still thinking it
> may be good to try, especially given the latest buzz
> regarding it being a good adjunct to lamictal.
>
> Any thoughts?
>
> Thanks,
> john
>John, tension headaches and migraines are quite opposite from each other with regards to vascular effects. Anything that might be effective for migraines might exacerbate tension headaches and vice versa. Tension headaches that I have experienced often involve excess use of stimulants like caffeine for example, while caffeine tends to help migraine sufferers.
As far as AED's go: Topamax and Gabitril were the worst for cognitive side effects that I have experienced. I felt like someone rubbed my forehead down with lidocaine and then slugged me with a large Masonic Bible!
Mitch
>
> > > Hi,
> > >
> > > I just started (last night first dose) on Topomax as a migraine prophylaxis.
> > >
> > > I don't have a history of any psychological disorders. just found this site through a Google search and you guys sound really knowledgeable.
> > >
> > > I've had migraines for most of my adult life and in the last few months they've become daily occurences. I've been taking Zomig and Ibuprofen to combat attacks -- have tried lots of other meds, too, both preventive and "abortive."
> > >
> > > My doctor, a headache specialist, recommended Topomax based on some very favorable results in his other patients.
> > >
> > > I'm a bit worried about side effects. They started me on 15 mg/day to increase by 15 mg each week until either the daily migraines go away or I reach 90 mg/day.
> > >
> > > I'm not taking any other neurological drugs.
> > >
> > > I'm a bit worried about the side effects. I do feel a bit groggy today but I don't know if it's from the Topomax. Is this commmon? Does it go away?
> > >
> > > My doctor mentioned tingling fingers, loss of mental acuity, depression, weight loss (not a negative in my opinion!) and dehydration.
> > >
> > > Has anyone experienced any of these? I'm particularly worried about the loss of mental acuity and grogginess since I need my brain power! I'm also worried about depression because I've seen what a horrible disease that can be.
> > >
> > > And I'd like to know if the side effects tend to go away with time. If so, how long does it take?
> > >
> > > If anyone has any advice, comments, experiences, etc. on taking Topomax for migraines, I'd appreciate it.
> > >
> > > Thanks!
> >
> >
> > Hi Inky,
> >
> > It seems that more anti-epielpsy meds are starting to be used for migraine prophylaxis. I know Depakote has been used for that and has an approvable indication for that purpose.
> >
> > I have tried Topamax for my bipolar. Lots of others here have tried it as well for various things (mostly bipolar disorder). All I can say is that it *can* cause some fairly bad cognitive dulling effects. I wouldn't say that it is all that "depressogenic". As with many meds nowadays you have to start low and go slow with dose increases. I made it up to 50mg/day for a while with other meds added on and I was pretty foggy-headed. Many people here have had little trouble with that if you hang with a dose long enough before you increase it. 15mg to start was where I started. I would continue taking the 15mg/day dose until the "tiredness" or whatever seems to abate *before* you go up a notch in the dosage FWIW,
> >
> > Mitch
Posted by bob on November 12, 2001, at 23:44:58
In reply to Re: Starting on Topomax for Migraines. Advice anyone? » JohnX2, posted by Mitch on November 12, 2001, at 22:56:23
Mitch:
That quote about the lidocaine and the Masonic Bible was absolutely priceless. I have to admit that the cognitive dysfunction arising out of drugs like Topomax in practically unbearable -- at least with my experience.
Posted by Mitch on November 13, 2001, at 9:15:41
In reply to Re: Starting on Topomax for Migraines. Advice anyone?, posted by bob on November 12, 2001, at 23:44:58
> Mitch:
>
> That quote about the lidocaine and the Masonic Bible was absolutely priceless. I have to admit that the cognitive dysfunction arising out of drugs like Topomax in practically unbearable -- at least with my experience.Bob,
I've got comorbid adult ADHD mixed up with bipolarII problems. For whatever reason, it seems that the AED's that affect GABA in some way appear to be the worst ones. I think one of the mechanisms of Topamax is GABA-ergic in some way as well (I might be wrong here). Gabitril was clearly the worst one (it blocks reuptake of GABA). Even with just a 4mg dose, I could go to work and find myself starting things over and over again. When I was taking 500mg/day of Depakote (for nearly two years), I was trying to train somebody at work and I remember her turning around and looking straight at me and saying, "Do you have attention deficit disorder, or something?". That was before the comorbid ADHD dx. I wonder if a lot of other BP's out there are misdiagnosed or the comorbid condition is missed.
Mitch
Posted by AHP on November 13, 2001, at 9:33:30
In reply to Re: Topamax Experiences?, posted by Janice1 on January 4, 2001, at 18:52:01
I won't tell you how many medications that I am on already, but when I added topamax, my life changed for the better. Now it could be that my illness has just gone into a natural remission and it is a coincidence, but since I was diagnosed six years ago as a mixed states, rapid cyclying bipolar I, my life had not been the same. Then topamax came into the picture last year, and I have had the most incredibly pleasant year you can imagine. I am up to 500 mg now, I may go to 600 mg, but eigther way, I am thrilled. I am not embarrassed to admit that it was the answer to some serious praying that I was doing at the time...and even though Topamax may be a stepping stone to my final health plan, I would recommend it to anyone to at least give it a try if NOTHING else is working. I feel like a normal human being again.
Anna
Posted by JohnX2 on November 13, 2001, at 9:48:15
In reply to Re: Starting on Topomax for Migraines. Advice anyone? » JohnX2, posted by Mitch on November 12, 2001, at 22:56:23
Thanks for your feedback.I was getting mad at the neurologist because
he wanted to throw migraine headache medicines
at my tension headaches, and I had absolutely
no symptoms of migraine. Anyways, I did a bit
of research on tension headaches, which are
less vascular, and more related to muscle
contraction spasms. I found that SSRIs can induce
them in an area of the brain where dopamine
counteracts acetylcholine in the stimulation of
the masseter (jaw) muscles. These dopamine neurons
are unique in that they do not contain self
regulating auto-receptors. Their firing is gated
by serotonin receptors (proportional to 5ht-1a
post synaptictic and inversely proportional to
5ht-2a receptors) at the junction and also by
dopaminergic projections from a pool of dopamine
neurons at the VTA where there are other somotodendric
dopamine neurons gated in a similar manner but by
many afferents (it does have the same serotonin
input). The serotonin input can be exacerbated
by stress. Stress can cause greater serotonin
impulses due to interesting cross talk with
the noradrenergic stress center (the locus
coerulus) and all this indirectly can lead to
bruxism and tension headache because of the
goofed up dopamine modulation. In the hypo-dopaminergic
state a dopaminergic med like Adderall makes the
headache go away, so do 5ht-2a antagonists. This
is in the literature and also my experience.
Klonopin slows the firing of those serotonin
neurons and so does buspar, which gives them
potential therapeutic advantages. I was hoping
that maybe Topomax could achieve some of the
same goals as klonopin, but the feedback on it
hasn't been overwhelmingly positive in this
regard.Thanks.
-john
> >
> > Hi,
> >
> > Topomax is one of the few anti-convulsants I have
> > not tried. I have chronic tension headache and
> > bruxism and lately was suggested baclofen. But
> > my older neurologist thouht Topomax may help.
> > I never got substantial relief from the other
> > anti-convulsants, but i am currently taking lamictal
> > and klonopin is the main releaver of my headaches.
> > When I looked into topomax I saw it worked very
> > differently than lamictal and it had action at the
> > GabaA receptor increasing Cl- conductance which is
> > also what klonopin does. So I was still thinking it
> > may be good to try, especially given the latest buzz
> > regarding it being a good adjunct to lamictal.
> >
> > Any thoughts?
> >
> > Thanks,
> > john
> >
>
> John, tension headaches and migraines are quite opposite from each other with regards to vascular effects. Anything that might be effective for migraines might exacerbate tension headaches and vice versa. Tension headaches that I have experienced often involve excess use of stimulants like caffeine for example, while caffeine tends to help migraine sufferers.
>
> As far as AED's go: Topamax and Gabitril were the worst for cognitive side effects that I have experienced. I felt like someone rubbed my forehead down with lidocaine and then slugged me with a large Masonic Bible!
>
>
> Mitch
>
>
> >
> > > > Hi,
> > > >
> > > > I just started (last night first dose) on Topomax as a migraine prophylaxis.
> > > >
> > > > I don't have a history of any psychological disorders. just found this site through a Google search and you guys sound really knowledgeable.
> > > >
> > > > I've had migraines for most of my adult life and in the last few months they've become daily occurences. I've been taking Zomig and Ibuprofen to combat attacks -- have tried lots of other meds, too, both preventive and "abortive."
> > > >
> > > > My doctor, a headache specialist, recommended Topomax based on some very favorable results in his other patients.
> > > >
> > > > I'm a bit worried about side effects. They started me on 15 mg/day to increase by 15 mg each week until either the daily migraines go away or I reach 90 mg/day.
> > > >
> > > > I'm not taking any other neurological drugs.
> > > >
> > > > I'm a bit worried about the side effects. I do feel a bit groggy today but I don't know if it's from the Topomax. Is this commmon? Does it go away?
> > > >
> > > > My doctor mentioned tingling fingers, loss of mental acuity, depression, weight loss (not a negative in my opinion!) and dehydration.
> > > >
> > > > Has anyone experienced any of these? I'm particularly worried about the loss of mental acuity and grogginess since I need my brain power! I'm also worried about depression because I've seen what a horrible disease that can be.
> > > >
> > > > And I'd like to know if the side effects tend to go away with time. If so, how long does it take?
> > > >
> > > > If anyone has any advice, comments, experiences, etc. on taking Topomax for migraines, I'd appreciate it.
> > > >
> > > > Thanks!
> > >
> > >
> > > Hi Inky,
> > >
> > > It seems that more anti-epielpsy meds are starting to be used for migraine prophylaxis. I know Depakote has been used for that and has an approvable indication for that purpose.
> > >
> > > I have tried Topamax for my bipolar. Lots of others here have tried it as well for various things (mostly bipolar disorder). All I can say is that it *can* cause some fairly bad cognitive dulling effects. I wouldn't say that it is all that "depressogenic". As with many meds nowadays you have to start low and go slow with dose increases. I made it up to 50mg/day for a while with other meds added on and I was pretty foggy-headed. Many people here have had little trouble with that if you hang with a dose long enough before you increase it. 15mg to start was where I started. I would continue taking the 15mg/day dose until the "tiredness" or whatever seems to abate *before* you go up a notch in the dosage FWIW,
> > >
> > > Mitch
Posted by Mitch on November 13, 2001, at 12:58:51
In reply to Re: Starting on Topomax for Migraines. Advice anyone? » Mitch, posted by JohnX2 on November 13, 2001, at 9:48:15
>Anyways, I did a bit
> of research on tension headaches, which are
> less vascular, and more related to muscle
> contraction spasms. I found that SSRIs can induce
> them in an area of the brain where dopamine
> counteracts acetylcholine in the stimulation of
> the masseter (jaw) muscles. These dopamine neurons
> are unique in that they do not contain self
> regulating auto-receptors. Their firing is gated
> by serotonin receptors (proportional to 5ht-1a
> post synaptictic and inversely proportional to
> 5ht-2a receptors) at the junction and also by
> dopaminergic projections from a pool of dopamine
> neurons at the VTA where there are other somotodendric
> dopamine neurons gated in a similar manner but by
> many afferents (it does have the same serotonin
> input). The serotonin input can be exacerbated
> by stress. Stress can cause greater serotonin
> impulses due to interesting cross talk with
> the noradrenergic stress center (the locus
> coerulus) and all this indirectly can lead to
> bruxism and tension headache because of the
> goofed up dopamine modulation. In the hypo-dopaminergic
> state a dopaminergic med like Adderall makes the
> headache go away, so do 5ht-2a antagonists. This
> is in the literature and also my experience.
Aha! So, that's why I grind my teeth and get headaches from Zoloft. That is interesting about the 5-HT2a antagonists. Maybe you ought to pitch some Serzone in there (if you are not already)? I noticed that when I took Serzone I had greatly reduced *agitation* and restlesslness and didn't experience any headache or stomach upset (at low doses). The trouble with Serzone was mild pruritis and amyblyopia (big time-had difficulty reading).
Maybe a little Serzone with a little Adderall in combination with a mood stabilizer?? Hmm.Mitch
Posted by JohnX2 on November 13, 2001, at 18:31:22
In reply to Re: Starting on Topomax for Migraines. Advice anyone?, posted by Mitch on November 13, 2001, at 12:58:51
Guess what Mitch,The paper discussing this phenomena was
specifically siting cases of Zoloft! I can
send you a print if you send me an email address.It recommended buspar as one anti-dote, another
is a 5ht-2a antagonist. It suggested Serzone (which
worked great for me) or possibly Remeron (not quite
great). Didn't mention atypical anti-psychotics, but
I believe that a dabble of zyprexa et. al may do the
trick to.The future of the serotonin drugs are either stand alone
SSRIs with *clean* 5ht-2 antagonism (not dirty like serzone)
and/or an SSRI with a mixed in clean 5ht-2 antagonist.
Get rid of those potential rls,eps,sexual dysfunction,
tension headache,agitation, side effects...
But what pharmaceutical company will win this horse
race? Tell me and I'll buy the stock!
There are from what I understand clean (selective)
5ht-2a antagonists in the pipeline and with celexa and
prozac going off patent I could see those manufacturers
bundling the clean 5ht-2a meds with the generics in one
pill....-john
> >Anyways, I did a bit
> > of research on tension headaches, which are
> > less vascular, and more related to muscle
> > contraction spasms. I found that SSRIs can induce
> > them in an area of the brain where dopamine
> > counteracts acetylcholine in the stimulation of
> > the masseter (jaw) muscles. These dopamine neurons
> > are unique in that they do not contain self
> > regulating auto-receptors. Their firing is gated
> > by serotonin receptors (proportional to 5ht-1a
> > post synaptictic and inversely proportional to
> > 5ht-2a receptors) at the junction and also by
> > dopaminergic projections from a pool of dopamine
> > neurons at the VTA where there are other somotodendric
> > dopamine neurons gated in a similar manner but by
> > many afferents (it does have the same serotonin
> > input). The serotonin input can be exacerbated
> > by stress. Stress can cause greater serotonin
> > impulses due to interesting cross talk with
> > the noradrenergic stress center (the locus
> > coerulus) and all this indirectly can lead to
> > bruxism and tension headache because of the
> > goofed up dopamine modulation. In the hypo-dopaminergic
> > state a dopaminergic med like Adderall makes the
> > headache go away, so do 5ht-2a antagonists. This
> > is in the literature and also my experience.
>
>
> Aha! So, that's why I grind my teeth and get headaches from Zoloft. That is interesting about the 5-HT2a antagonists. Maybe you ought to pitch some Serzone in there (if you are not already)? I noticed that when I took Serzone I had greatly reduced *agitation* and restlesslness and didn't experience any headache or stomach upset (at low doses). The trouble with Serzone was mild pruritis and amyblyopia (big time-had difficulty reading).
> Maybe a little Serzone with a little Adderall in combination with a mood stabilizer?? Hmm.
>
> Mitch
Posted by Mitch on November 13, 2001, at 23:35:31
In reply to Re: Starting on Topomax for Migraines. Advice anyone? » Mitch, posted by JohnX2 on November 13, 2001, at 18:31:22
>
> Guess what Mitch,
>
> The paper discussing this phenomena was
> specifically siting cases of Zoloft! I can
> send you a print if you send me an email address.John, thanks for the feedback, but I really don't need *that* much detail :)-I am on the computer enough as it is (between the web and my work!-eek, that sounds a little macabre somehow).
>
> It recommended buspar as one anti-dote, another
> is a 5ht-2a antagonist. It suggested Serzone (which
> worked great for me) or possibly Remeron (not quite
> great). Didn't mention atypical anti-psychotics, but
> I believe that a dabble of zyprexa et. al may do the
> trick to.Well, can't do Remeron or Buspar due to the alpha-2 antagonist induced irritability (more "dirty" meds hitting receptors like a pin-ball game). If I went back on Serzone I would have to put up with some itching and difficulties seeing/reading, plus it is not very "liver-friendly", either.
>
> The future of the serotonin drugs are either stand alone
> SSRIs with *clean* 5ht-2 antagonism (not dirty like serzone)
> and/or an SSRI with a mixed in clean 5ht-2 antagonist.
> Get rid of those potential rls,eps,sexual dysfunction,
> tension headache,agitation, side effects...
> But what pharmaceutical company will win this horse
> race? Tell me and I'll buy the stock!
> There are from what I understand clean (selective)
> 5ht-2a antagonists in the pipeline and with celexa and
> prozac going off patent I could see those manufacturers
> bundling the clean 5ht-2a meds with the generics in one
> pill....
>
> -johnProbably what is going on there is just bottom-line economics (not that I disapprove-they are also rolling bucks into the *new* stuff). When we start to see the patents expiring for Zoloft, Paxil, and Celexa-THAT is when we will probably see the meds you are talking about start "coming to the surface". If you can make an SSRI tolerable-wow that's where the money would be.
Mitch
> > >Anyways, I did a bit
> > > of research on tension headaches, which are
> > > less vascular, and more related to muscle
> > > contraction spasms. I found that SSRIs can induce
> > > them in an area of the brain where dopamine
> > > counteracts acetylcholine in the stimulation of
> > > the masseter (jaw) muscles. These dopamine neurons
> > > are unique in that they do not contain self
> > > regulating auto-receptors. Their firing is gated
> > > by serotonin receptors (proportional to 5ht-1a
> > > post synaptictic and inversely proportional to
> > > 5ht-2a receptors) at the junction and also by
> > > dopaminergic projections from a pool of dopamine
> > > neurons at the VTA where there are other somotodendric
> > > dopamine neurons gated in a similar manner but by
> > > many afferents (it does have the same serotonin
> > > input). The serotonin input can be exacerbated
> > > by stress. Stress can cause greater serotonin
> > > impulses due to interesting cross talk with
> > > the noradrenergic stress center (the locus
> > > coerulus) and all this indirectly can lead to
> > > bruxism and tension headache because of the
> > > goofed up dopamine modulation. In the hypo-dopaminergic
> > > state a dopaminergic med like Adderall makes the
> > > headache go away, so do 5ht-2a antagonists. This
> > > is in the literature and also my experience.
> >
> >
> > Aha! So, that's why I grind my teeth and get headaches from Zoloft. That is interesting about the 5-HT2a antagonists. Maybe you ought to pitch some Serzone in there (if you are not already)? I noticed that when I took Serzone I had greatly reduced *agitation* and restlesslness and didn't experience any headache or stomach upset (at low doses). The trouble with Serzone was mild pruritis and amyblyopia (big time-had difficulty reading).
> > Maybe a little Serzone with a little Adderall in combination with a mood stabilizer?? Hmm.
> >
> > Mitch
Posted by JohnX2 on November 14, 2001, at 3:06:46
In reply to Re: Starting on Topomax for Migraines. Advice anyone? » JohnX2, posted by Mitch on November 13, 2001, at 23:35:31
> > It recommended buspar as one anti-dote, another
> > is a 5ht-2a antagonist. It suggested Serzone (which
> > worked great for me) or possibly Remeron (not quite
> > great). Didn't mention atypical anti-psychotics, but
> > I believe that a dabble of zyprexa et. al may do the
> > trick to.
>
> Well, can't do Remeron or Buspar due to the alpha-2 antagonist induced irritability (more "dirty" meds hitting receptors like a pin-ball game). If I went back on Serzone I would have to put up with some itching and difficulties seeing/reading, plus it is not very "liver-friendly", either.
>
I concur about the Remeron and Buspar a2 antagonism.
Neither helped as much as I would have liked.
The a2 antagonism increases the noradrenaline
conductice in that stress center that connects
to the serotonin path. So I think it counteracts
the 5ht-1a agonist in buspar and/or 5ht-2 antagonism
in Remeron.I've always wondered if buspar would have been
a better anxiolytic w/o the alpha-2 side effect.
It incidently probably helped sales as people
discovered at the high dose of 60 mg it had some
antidepressant effect likely due to this.PS. What is your current med cocktail?
Is it mainly Zoloft? I it would be novel to meet
someone on pbabble who was humming along on
1 ssri med. ;)Regards,
John
Posted by JohnX2 on November 14, 2001, at 3:18:21
In reply to Re: Starting on Topomax for Migraines. Advice anyone? » Mitch, posted by JohnX2 on November 14, 2001, at 3:06:46
Whoops Mitch, sorry I forgot about our other threads.
My bad. good luck with your meds. Hard to keep
track of everyone I have been in contact with
lately. I have taken so many meds over the past
3 years and learned so much. I wish these brain
cells were storing memories about traveling,
fun,relationships...but unfortunately they encode
psychopharmacology. Hopefully I can spare a few
of you from wasting brain cells on this with
some answers the pdocs don't readily provide.-john
> PS. What is your current med cocktail?
> Is it mainly Zoloft? I it would be novel to meet
> someone on pbabble who was humming along on
> 1 ssri med. ;)
>
> Regards,
> John
Posted by Mitch on November 14, 2001, at 9:03:28
In reply to Re: Starting on Topomax for Migraines. Advice anyone? » Mitch, posted by JohnX2 on November 14, 2001, at 3:06:46
>
> PS. What is your current med cocktail?
> Is it mainly Zoloft? I it would be novel to meet
> someone on pbabble who was humming along on
> 1 ssri med. ;)
>
> Regards,
> John
Oh sure,Neurontin 300mg/day
Klonopin .5-1.0mg/day
Zoloft (12.5mg divided over *six* days-yes I am that SSRi sensitive!)Plus an occasional 125-250mg tab of Depakote to "tap the brakes" and get me slowed down a little during my highs. Plus an occasional 10mg cap of nortripytline for irritable bowel (from the Zoloft).
Mitch
Posted by shersher on January 3, 2002, at 20:16:29
In reply to Re: Topamax Experiences: Long Term Use, posted by Lexie on March 25, 2001, at 8:27:21
it seems like so many of you have bailed out on topamax.... so how are all of you doing now????
What are your doses now and what are the side effects?
I am new to this site and relatively new to topamaxx
I could use some advice
sher
Posted by KimberlyL on January 4, 2002, at 3:02:10
In reply to Topamax Experiences?, posted by Kingfish on January 4, 2001, at 7:29:48
> Hi! I've posted a few times and wanted to check in and see if anyone else has had success with Topamax. I've taken it for about two months. At first the side effects were terrible but they've subsided and it seems to be helping tremendously. I'm up to 100 mg a day and 40 mg of Celexa.
>
> Thanks for any input!
>
> - KellyHi Kelly,
I too am curious. I am a new user to Topamax and on the same combo as you...Celexa + Topamax. My dosages are 20 mgs of Celexa and 25 mgs of Topamax. I've taken Celexa for about 9 months but just starting the Topamax.What were your early side effects?
Thanks,
Kim
Posted by Krazy Kat on January 4, 2002, at 11:30:20
In reply to Re: Topamax Experiences?}}Kingfish, posted by KimberlyL on January 4, 2002, at 3:02:10
Kim:
I've gonet hrough several other meds since this combo. I could never get over the sedation caused by Topamax. Alomost as soon as I stopped, the sedation went away. I also noticed the relief from cognitive side effects - I finally admitted it is called "Dopamax" for a reason. Also the Celexa jusst didn't seem strong enough in the long run.
If you can get by on a low dose of Topamax, I think it helps. I experienced tingling fingers, slow speech, and a strange taste in my mouth for about a month in a half.
- K.
Posted by JohnX2 on January 4, 2002, at 16:31:03
In reply to Re: Topamax Experiences: Long Term Use, posted by shersher on January 3, 2002, at 20:16:29
> it seems like so many of you have bailed out on topamax.... so how are all of you doing now????
> What are your doses now and what are the side effects?
> I am new to this site and relatively new to topamaxx
> I could use some advice
> sherI started topamax a number of weeks ago. I take 400 mg for
myofacial pain and bipolar II. I have almost no side
effects and it completely alleviates myofacial
pain that klonopin was the only med we could
find that worked. So for me it has been a total
success to date. I was able to bump the dose
extremely rapidly. I even tried 600 mg and it
didn't even phase me. I hope it doesn't poop
out.-john
Posted by Krazy Kat on January 5, 2002, at 11:03:36
In reply to Re: Topamax Experiences: Long Term Use » shersher, posted by JohnX2 on January 4, 2002, at 16:31:03
John:
I'm glad it's working for you. During my @6 month experience with it, it didn't phase out, so hopefully it will continue to provide you with relief.
- K.
Posted by djmmm on January 5, 2002, at 14:22:47
In reply to Re: Topamax Experiences: Long Term Use, posted by shersher on January 3, 2002, at 20:16:29
> it seems like so many of you have bailed out on topamax.... so how are all of you doing now????
> What are your doses now and what are the side effects?
> I am new to this site and relatively new to topamaxx
> I could use some advice
> sherI've been taking Topamax for about a year and 1/2 @ 200mg (along with 1800mg of Neurontin) for Epilepsy...as with most psychiatric drugs, the side effects become less pronounced over time...I never really had any problems with Topamax, or Neurontin for that matter.
Posted by shersher on January 6, 2002, at 7:34:48
In reply to Re: Topamax Experiences: Long Term Use » shersher, posted by JohnX2 on January 4, 2002, at 16:31:03
> > it seems like so many of you have bailed out on topamax.... so how are all of you doing now????
> > What are your doses now and what are the side effects?
> > I am new to this site and relatively new to topamaxx
> > I could use some advice
> > sher
>
> I started topamax a number of weeks ago. I take 400 mg for
> myofacial pain and bipolar II. I have almost no side
> effects and it completely alleviates myofacial
> pain that klonopin was the only med we could
> find that worked. So for me it has been a total
> success to date. I was able to bump the dose
> extremely rapidly. I even tried 600 mg and it
> didn't even phase me. I hope it doesn't poop
> out.
>
> -john
thanks for the message
that sounds like alot of topa for me... I can hardly tolerate 200mg but I am also takin lithium and zoloft. I have 5 kids so I have to stay really alert all the time and can't afford to be cloudy... but you sound great!!!
thanks again
sher
Posted by shersher on January 6, 2002, at 7:39:25
In reply to Re: Topamax Experiences: Long Term Use, posted by djmmm on January 5, 2002, at 14:22:47
> > it seems like so many of you have bailed out on topamax.... so how are all of you doing now????
> > What are your doses now and what are the side effects?
> > I am new to this site and relatively new to topamaxx
> > I could use some advice
> > sher
>
> I've been taking Topamax for about a year and 1/2 @ 200mg (along with 1800mg of Neurontin) for Epilepsy...as with most psychiatric drugs, the side effects become less pronounced over time...I never really had any problems with Topamax, or Neurontin for that matter.Thanks for your input
I have just started back on topamax with lithium and am having good results. I am also still on 100 mg of zoloft as well. I just never knew it would take so many different drugs to stabilze one disease!!! Its so hard sometimes!! But this website is so awesome for the support and to see everyone else's struggles. You don't feel so alone and maybe a little less crazy!!!
sher
Posted by shersher on January 6, 2002, at 7:52:17
In reply to Re: Topamax Experiences?}}Kingfish, posted by KimberlyL on January 4, 2002, at 3:02:10
> > Hi! I've posted a few times and wanted to check in and see if anyone else has had success with Topamax. I've taken it for about two months. At first the side effects were terrible but they've subsided and it seems to be helping tremendously. I'm up to 100 mg a day and 40 mg of Celexa.
> >
> > Thanks for any input!
> >
> > - Kelly
>
> Hi Kelly,
> I too am curious. I am a new user to Topamax and on the same combo as you...Celexa + Topamax. My dosages are 20 mgs of Celexa and 25 mgs of Topamax. I've taken Celexa for about 9 months but just starting the Topamax.
>
> What were your early side effects?
>
> Thanks,
> KimHi I'm Sher
I don't know if you've been reading any of my threads, but I have started taking topamax in the last couple of months as well. I have been bp all my life but not stable until the last 5 years until I was on lithium(900mg) and zoloft(100mg). I gained about 30 lbs however, and my pdoc switched me to topa and zoloft. I was working up to 200mg of topamax and had a pretty severe hypomanic almost manic phase and my husband said -NO WAY. We have 5 kids and he rather me fat than manic!!! So now I am on 450 of li, 200 topa and 25 of zol and I FEEL GREAT!!!!!
We will see how long thisa lasts!!! what is your story???
sher
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