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Dr. Bob is Robert Hsiung, MD,
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Posted by Toby on May 12, 1999, at 8:27:31
In reply to Re:topamax & dullness????, posted by Nancy on April 28, 1999, at 13:36:37
I don't want to be the big naysayer, but i would ask you to think a little about your doc's suggestion that you do research for him. Shrinks are just not supposed to have any kinds of dealings with their patients outside of the treatment relationship. It's an APA ehtical guideline. Psychiatrists have a fiduciary relationship with their patients, meaning a protective, nonexploitative relationship. The psychiatrist is not supposed to gain anything from the relationship other than a fee for services rendered and possibly an inner glow at seeing a patient do well. A social relationship, a work relationship, gifts, etc are just not supposed to develop because once a shrink has a vested interest in the patient other than professional, boundaries begin to blur and it becomes difficult for the doctor to see the patient's symptoms as symptoms, as problems to be remedied, and instead begins seeing the person as a friend or a business partner or employee or employer or whatever and once that point is reached, the doctor becomes useless as a therapist or even as a psychopharmacologist because the doctor is then treating the symptoms that bother him as they relate to his social interactions with the patient. This is why doctors are prohibited from treating family and friends. Of course, many doctors do treat family and friends and when this is discovered they often lose their license or at the very least have to go through alot of investigation and probation. And why? Because no matter how good the doctor is and no matter how wonderful their clinical judgement is, when it comes to family and friends, one cannot be properly objective and important symptoms will be missed just because they are familiar or minor symptoms will be overtreated because they annoy the doctor or because he can't say "no" now that he's been treating them for so long.
I've probably over-explained this, but I just want you to beware of the possible implications this could have on your treatment with him and/or your research work with him. What if you get well and start researching for him and then relapse and start doing poorly in your research? Is he in enough control of his feelings that he could see the symptoms returning early and not blame you for delayed publishing or faulty results and is he in enough control that this wouldn't bleed over into your psychiatric treatment? And if he had to let you go from the research job, could he still treat your illness effectively and could you still trust him with your treatment if you resented him terminating your job? And why did he spend so much time at your last appointment talking about what you could do for him rather than talking about your treatment? I realize you wanted to talk about it too because that is your interest, but for him, it is a slippery slope. Again, I want you to be able to return to your research and from your postings, I see your intelligence and am hopeful that this will be a reality for you, but I want you to be aware of the pitfalls of what your doctor proposed so you can make a good decision when the time comes.
Posted by Ellen Brodie on May 12, 1999, at 19:08:30
In reply to Re: topomax, posted by katie on April 20, 1999, at 22:38:44
> Nancy, I have been on Topmax for almost three weeks now. I have had a sugnificant decrease in appetite but I am not sure if that is the depression or the medication. It has made a sginificant diffence in helping to stbailizing my moods. I was starting with taking Klonopin at about 20mg a day now I am down to about half that anount. I am taking 200 mg of the topomax and have had bee please in the way it has helped my moods. Lots of side effects. Psycho motor slowing, cognitive dulling, definite taste changes, tingles in fingers. speech patterns have slowed almost to the point of stuttering, I am hoping over time these will lessen, My thoughts to these sides effects, I will take them to suicide attempts anyday. I have opted not to add a anti depressant to mt med care as i have done enougth research and I have not heard enough positve info that manic depressive patients do well on anti depressants. I woulld not go on depakote or litium because if weight gain. I am going to stick it out with the topomax and see how it goes. I can handle the side effects for now. I have learned to laugh at myself and am trying to have a good sense of humour. Positve self talk helps. Please let me now how your doing. Good Luck. Ellen
Posted by Chris A. on May 16, 1999, at 4:10:09
In reply to Re: topomax, posted by Ellen Brodie on May 12, 1999, at 19:08:30
To my friends who suffer from bipolar,
Posted by Aaron Friedman on May 27, 1999, at 20:49:47
In reply to Re: topamax, posted by Nancy on April 26, 1999, at 18:51:16
> I was taking 100 mgs(and still on my way up in dosage) of Topomax. But, my pdoc has just stopped prescribing Topomax completely, because of a medical conference that he recently attended. So, I'm on Seroquel for the long run, I guess. :) Take care....N
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> > What kinds of doses are working for you ladies? I've seen everything from 100 mg per day to 600 mg per day in the studies, but the studies also indicate that the higher doses make people cognitively dull. I have only one patient on it now (at 100 mg) and she's still got a little bit in the way of hypomania so we're slowly going to go up to 150 mg. She's very bright and in graduate school so I'm being cautious because I don't want to dull her intellect or creativeness, but at the same time when she's manic she doesn't get a whole lot of useful activities done either. I'm hoping we can find a happy medium with the Topamax.I hav sone information on Topamax.. If the titration period is done at a very very slow rate (starting @ 25mg and inc @ 25mg per week the side effects are lessened
Posted by Ellen Brodie on May 28, 1999, at 5:34:48
In reply to Re: topamax, posted by Aaron Friedman on May 27, 1999, at 20:49:47
> I am now on 300mg a day of topomax. My doc has been uping the prescription at 50mg about every 10 days. As the time as gone on I have notice consideraberably less cognitive dulling. At first I was at the reading level or at least felt like I was at the reading level of a twelve year old. I am thirthy six. It has helped stabilized my moods and the side efects have decreased over time. I am also taking klonopin. I am bipolar and have a generalized anxiety disorder. I hope this helps. Good Luck. Ellen
Posted by Georgia F on May 29, 1999, at 23:27:30
In reply to Re: topamax, posted by Ellen Brodie on May 28, 1999, at 5:34:48
> > I am now on 300mg a day of topomax. My doc has been uping the prescription at 50mg about every 10 days. As the time as gone on I have notice consideraberably less cognitive dulling. At first I was at the reading level or at least felt like I was at the reading level of a twelve year old. I am thirthy six. It has helped stabilized my moods and the side efects have decreased over time. I am also taking klonopin. I am bipolar and have a generalized anxiety disorder. I hope this helps. Good Luck. Ellen
i am new to the whole ballgame of bipolar plus all of the medications involved...in the last year and and a half...i have been on a roller coaster of pills and doctors and side effects. I seem to not know what is wrong with me. The only thing they all agree on is ...i am bipolar..hard thing to find out at the late age...i was just kooky until now....i have been on lithium until three weeks ago among other things...and talk about extra weight...want some? 75 lbs in 14 months and now this incredible edema...i can barely walk...and i have 4 doctors telling me 4 different things...HELP!
Posted by Ellen Brodie on May 30, 1999, at 7:10:46
In reply to Re: topamax, posted by Aaron Friedman on May 27, 1999, at 20:49:47
> My doc took me up to 300mg of topomax. it was way to much in terms of the side effects. Actually the cognitive dulling has lessened alot but the anxiety was awful. I had her drop it back. I will proably have her go back to about 225. I seem to be able to stabilize my moods at that dosage. I notice though that my moods are the worse around my mentrual cycle. Any women out there concur with me!. Wish they that we could take pills just for that time of the month! HA!.
Posted by Georgia F. on May 30, 1999, at 18:15:51
In reply to Re: topamax, posted by Georgia F on May 29, 1999, at 23:27:30
disorder. I hope this helps. Good Luck. Ellen
>
> i am new to the whole ballgame of bipolar plus all of the medications involved...in the last year and and a half...i have been on a roller coaster of pills and doctors and side effects. I seem to not know what is wrong with me. The only thing they all agree on is ...i am bipolar..hard thing to find out at the late age...i was just kooky until now....i have been on lithium untilthree weeks ago among other things...and talk about extra weight...want some? 75 lbs in 14 months and now this incredible edema...i can barely walk...and i have 4 doctors telling me 4 different things...HELP!
yesterday i tried posting here...the 75 lbs woman....by the way my name is Georgia...duh..see there is also increased fat in head...lol...i just began the topamax two weeks ago along with serzone and resperdal...any advice?
thanks.....since i am dense...may be easier to emaild me...georgia
Posted by Ellen Brodie on May 30, 1999, at 18:56:01
In reply to Re: topamax, posted by Georgia F. on May 30, 1999, at 18:15:51
>i don't want to start handing out advice that I am not qualified to give but it sounds to be like you don't have much confidence on your doctors or your diagnosis. Find competent medical care. I have been through many doctors and have only in the past year gotten good treatment, but it was through alot of pain and effort that I got it. I was hospitalized once. Do your own research, read if you can and educate yourself as much as you can. If you need to e-mail me or want to chat more my e-mail is bodywizard@aol.com. Good Luck! trust me! You don'r need to suffer! Ellen
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> yesterday i tried posting here...the 75 lbs woman....by the way my name is Georgia...duh..see there is also increased fat in head...lol...i just began the topamax two weeks ago along with serzone and resperdal...any advice?
> thanks.....since i am dense...may be easier to emaild me...georgia
Posted by mj on May 10, 2000, at 15:09:33
In reply to Re: topamax, posted by Ellen Brodie on May 30, 1999, at 18:56:01
Has anyone LOST any weight with this topomax. I have gained 75lbs on lithium and zyprexa with dieting and exercising with a personal trainer. If anyone's had any luck with losing the weight please let me know how. Thanks
Posted by Brenda on May 12, 2000, at 13:30:21
In reply to Re: topamax, posted by mj on May 10, 2000, at 15:09:33
> Has anyone LOST any weight with this topomax. I have gained 75lbs on lithium and zyprexa with dieting and exercising with a personal trainer. If anyone's had any luck with losing the weight please let me know how. Thanks
Mj - I was on Topamax 100 mg. for about two months. I did experience loss of appetite. I was also on Wellbrutrin at the time and had absolutely no desire for food. It was actually a problem, as I have low blood sugar and would get hypoglycemic.
Good luck, Brenda
Posted by CH on May 31, 2000, at 13:34:46
In reply to Re: topamax, posted by Ellen Brodie on May 30, 1999, at 18:56:01
I'm currently taking Topamax and does curb your appetite. I've lost a few pounds.
Posted by kady on June 2, 2000, at 13:24:38
In reply to Re: topamax, posted by CH on May 31, 2000, at 13:34:46
From prior postings here I found the majority of people lose weight while on Topomax. What I have just read in this long thread though makes me ponder. I am seeing a neurologist after suffering from migraines for the past 7 years. The GYN nor the Pri Care seemed to be able to take care of the problem. I am now in the stages of trying out different migraine meds to see if any work or react badly. Last follow up the neuro mentioned this Topomax. He is prescribing it to some with migraines. Why would this be? Also, I am reading much to do with bi polar, depression, and this Dr advised me this was a new drug to treat seizures. I know it all happens in the brain and sometimes chemically, I am just trying to put together why this is prescribed for so many different things. Anyone have any knowledge on this? By the way, the weight loss thing, this Dr states his most hopeless migraine case is a woman who just recently underwent some gastro surgery to help her lose weight. Since on Topomax, she is losing weight for the first time in her life! And the migraines are treated. I too am curious as to what Nancy's reply will be on why her Dr will not prescibe it anymore. I am trying to find out as much as I can on this drug before taking it. My husband is on Dilantin after surgery for an AVM and I noticed much mental slowdown with him. He has been on it for 3 years now and is just starting to think quicker and more clearly. I wonder if all seizure realated meds have this "dulling" effect? Thanks
Posted by Amy O on June 7, 2000, at 13:37:14
In reply to Re: topamax, posted by CH on May 31, 2000, at 13:34:46
This is my first time writing in to anything like this, but I just started taking Topamax today and am curious about all the side effects I have been reading about. I was not aware of any cognitive "dulling" until reading about it just now. Is it very noticeable? I am only taking 25mg a day, then upping 25mg every two weeks until it reaches a suitable level. I am wondering though if this is the drug for me- It sounds like every one is very depressed- I have in the past suffered with bouts of depression,(these seem to come in waves) but my main concerns now are racing, eratic behavior, inability to focus on one thing (always thinking about what I should be doing) and a eating disorder- My doctor informed me topomax was very successful in treating an eating disorder (where 100mg of prozac failed) and has a calming effect. Anyone have symptoms like these??
Posted by brynn on July 12, 2000, at 16:20:07
In reply to Re: topamax, posted by Amy O on June 7, 2000, at 13:37:14
I recently began taking topomax yesterday and will
be taking 100mg a day 2 tablets in the morning and
at bedtime..i also take serezone(400), and wellbrutrin(100)
xr..Until now i have been diagnosed with major
depression, but i found out I am bipolar. Yet i am
still trying to deal with all that too. I hope I do
get better with the topomax and if i lose weight
great, but I noticed last night i could not sleep
soundly..maybe nerves about starting a new medication again..I
was taking depakote and Boom! i was sleeping like
a baby for the first time in years, my insomnia
has been pretty crazy b/c of my depression..well
now that i know i am bipolar it all makes sense the
moodswings, the ups and downs and all but one thing
is for sure I will say Depakote made my hair fall
out as quick as three days so plz, be careful
if you ever take this and thank god i am off of
it and i did not gain any more weight hopefully i
will lose the weight i have gained by being
depressed..I am a little scared of the cognitive
dulling effect..at what dosage does this happen,
and did any of you have any of the insomnia effect
i mentioned earlier-thx for your response to any of
this..
Posted by Janice on July 12, 2000, at 21:50:37
In reply to Re: topamax, posted by brynn on July 12, 2000, at 16:20:07
hi brynn,
I began Topamax about a month ago and have just had 2 decent nights of sleep--Finally! I thought the Topamax was supposed to make me drowsy.My mood is stable and good, with no cognitive dulling. Good luck with it. The sleeplessness was a surprise to me too. Janice.
Posted by Moe on July 14, 2000, at 22:08:44
In reply to Re: topamax, posted by Janice on July 12, 2000, at 21:50:37
Hi all.
I have a semi-long story, to be followed up by a question....maybe just a statement, I don't know, yet.
Okay, I was hit by a car 12 years ago, had a seizure at that time, had a head injury and partial paralysis. Since then, my memory / intellect/ motor functions are back to where they were before the accident (Which I am greatly thankful for), and I was just a normal 28 yr old. I finally got up the courage to ask my doctor for anti-depressants and was put on Prozac, which I have probably needed for at least 6 years. Anyway....the doctors did not think I would have any more seizures, nor did I, since I had been off Phenobarb for 10 years without incident (they thought it was probably trauma-induced), but I have had 2 in the past 4 months. I guess my question / statement is two-fold -- Do you think the Prozac could be causing the seizures? And, if I go on Topomax (Which the doctor has warned about before the last EEG), will it counter-act with the prozac or could I ask about going off the prozac (Not that I would want to....I love prozac!) for fear of counter-actions of the different drugs?
Posted by Karla on August 9, 2000, at 21:36:30
In reply to Re: topamax, posted by Moe on July 14, 2000, at 22:08:44
> Hi all.
> I have a semi-long story, to be followed up by a question....maybe just a statement, I don't know, yet.
> Okay, I was hit by a car 12 years ago, had a seizure at that time, had a head injury and partial paralysis. Since then, my memory / intellect/ motor functions are back to where they were before the accident (Which I am greatly thankful for), and I was just a normal 28 yr old. I finally got up the courage to ask my doctor for anti-depressants and was put on Prozac, which I have probably needed for at least 6 years. Anyway....the doctors did not think I would have any more seizures, nor did I, since I had been off Phenobarb for 10 years without incident (they thought it was probably trauma-induced), but I have had 2 in the past 4 months. I guess my question / statement is two-fold -- Do you think the Prozac could be causing the seizures? And, if I go on Topomax (Which the doctor has warned about before the last EEG), will it counter-act with the prozac or could I ask about going off the prozac (Not that I would want to....I love prozac!) for fear of counter-actions of the different drugs?I had been seizure free for 7 years and no meds. I took amitriptalyne (antidepressent) to try to prevent cluster headaches and also for depression. I was on a very low dose and it triggered a seizure. My dr. took me off the medicine asap. and I have been seizure free since (2 years). I am now on celexa and have had no seizure problem. In the inserts they warn you if you have a history of seizures they may cause them. So be carefull and good luck!
Posted by archer on September 10, 2000, at 8:10:43
In reply to Re: topomax, posted by nancy on April 21, 1999, at 12:00:06
hi im a new topomax user. after years of suffering from frequent, severe, mood swings and numerous meds i was finally sent for a psychiatric evaluation and taken off prozac and put on topomax. just stated this week with 25mg daily for the 1st 2wks. then 25mgs bid along with serzone. i am very hopeful at this point. i have put on 30 lbs this last year and am totally disgusted by my binge eating. any info will be welcomed. thanx for the outlet. archer
Posted by Janice on September 11, 2000, at 10:56:52
In reply to Re: topomax, posted by archer on September 10, 2000, at 8:10:43
hi archer,
I'm not sure what kind of information you are looking for, but I highly doubt that topamax will cause you to gain weight. I've heard after doses of 200mg, some people actually lose weight.
I'm on Topamax as a supplement mood stabilizer to lithium, and it has stopped my rapid cycling. This has been nothing short of a miracle for me since I have been rapid cycling for 15 years.
So many mood stabilizers cause weight gain and the best thing about Topamax is it doesn't. Increasing your dose slowly, which you are doing, will lessening the chances of any cognitive slowing (which is a possible side effect).
The best of luck to you, Janice
Posted by sg on September 17, 2000, at 22:21:22
In reply to Re: topamax, posted by kady on June 2, 2000, at 13:24:38
>
My situation is the exact same.. my neurologist put me on Topamax for migraines, sleep, and weight loss.. said nothing about seizures or bi-polar... I am concerned about the varied uses... In fact they think I have Fibromyalgia... Any and all info would be appreciated... I'm on 25mg 7days,50mg, 75mg etc... scaryFrom prior postings here I found the majority of people lose weight while on Topomax. What I have just read in this long thread though makes me ponder. I am seeing a neurologist after suffering from migraines for the past 7 years. The GYN nor the Pri Care seemed to be able to take care of the problem. I am now in the stages of trying out different migraine meds to see if any work or react badly. Last follow up the neuro mentioned this Topomax. He is prescribing it to some with migraines. Why would this be? Also, I am reading much to do with bi polar, depression, and this Dr advised me this was a new drug to treat seizures. I know it all happens in the brain and sometimes chemically, I am just trying to put together why this is prescribed for so many different things. Anyone have any knowledge on this? By the way, the weight loss thing, this Dr states his most hopeless migraine case is a woman who just recently underwent some gastro surgery to help her lose weight. Since on Topomax, she is losing weight for the first time in her life! And the migraines are treated. I too am curious as to what Nancy's reply will be on why her Dr will not prescibe it anymore. I am trying to find out as much as I can on this drug before taking it. My husband is on Dilantin after surgery for an AVM and I noticed much mental slowdown with him. He has been on it for 3 years now and is just starting to think quicker and more clearly. I wonder if all seizure realated meds have this "dulling" effect? Thanks
Posted by Karla on September 21, 2000, at 22:06:33
In reply to Re: topamax, posted by sg on September 17, 2000, at 22:21:22
I read on the internet when I was researching epilepsy the other day that the same neuron chemical that is responsible for epilepsy is also responsible for migraines. To much of it causes seizures, to little causes migraines. Many anti seizure medicines are used to treat migraines. I have mirgraines and cluster headaches. I have heard of Nurontin, Topamax, Dilantin, Depakote, and others being used. Also antidepressents are used to treat depression but are also used to treat headaches. Amitriptalyne, celexa, et . I am on Topamax (125 mg) and celexa (40 mg). Also heart medicines are used such as vepramil, propranol, inderol, etc. I am also on vepramil for my headaches.
The topamax and celexa both cause mental slowdown, tiredness, fatigue, lack of concentration, etc. but as your body gets used to it the effects are suppose to lesson. Another thing is key to the sucess of the drug Topamax is that it needs to be introduced to your body very slowley. 25 mg every 2 weeks. Keeping an am/pm balance. This will let your body adjust. If you get to tired or mentally slowed down they can slow down the increasing of the dosage. I have enjoyed being on it. I have tried all the medicines mentioned in my email and the topamax is the best tollorated by me so far. Good luck. go to www.rxlist.com and enter in topamax and it will bring up information
on the drug and give you all the possible side effects of the medicine even the rare ones. Good luck!
Posted by archer on September 22, 2000, at 21:51:00
In reply to Re: topamax, posted by Karla on September 21, 2000, at 22:06:33
>hey karla, thanks for the info on topomax. i was wondering why i was on such a small amount. i started on 25mg daily for 2wks, then 25mg bid this week, while starting 50mgs of serzone bid also this week. i've had trouble sleeping for the last 4 nites but figure thats because i weaned off the prozac for 2 weeks and that was completely out of my system. so i'll be patient for now. it was good to read your thread. thanks again. archer
Posted by Karla on September 23, 2000, at 14:43:08
In reply to Re: topamax » Karla, posted by archer on September 22, 2000, at 21:51:00
Archer, The trouble sleeping could be caused by the topamax also. The first week I was on Topamax I experience axiety and insomnia. It went away the second week. Then my dose was uped the third week and I again experience axiety and isomnia. The fourth week it went away. The sixth week on I have had no trouble with it. So it could be the topamax. Just a thought. Might want to mention it to your dr. and let him sort it out.
Posted by archer on September 24, 2000, at 19:50:08
In reply to Re: topamax, posted by Karla on September 23, 2000, at 14:43:08
>karla, thanks for feedback. i will bounce it off my dr. when i see him in oct. by then i will have been on topomax for 5 wks and serzone for 4 wks. im keeping track of strange things i notice so i can let him know. i realize these side effects disappear after weeks on the meds. but just in case they dont. ya know. ive heard great things about topomax and am very hopeful that it will help me along with some intense therapy. thanks again. archer
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