![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 145 to 169 of 1085. Go back in thread:
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
Posted by Krazy Kat on January 6, 2002, at 15:40:15
In reply to Re: Topamax Experiences?}}Kingfish, posted by shersher on January 6, 2002, at 7:52:17
Sher:
Thanks for your info. I couldn't continue Topamax b/c, for some reason, it made me Really tired. Otherwise, it did help with the mania at @250 mg. But, once I stopped, I realized how bad the cognitive effects were - that may not happen to you, may not make a difference to you if it does, but I did much better on Depakote.
- K.
Posted by KimberlyL on January 6, 2002, at 20:42:19
In reply to Re: Topamax Experiences?}}Kingfish » shersher, posted by Krazy Kat on January 6, 2002, at 15:40:15
> Sher:
>
> Thanks for your info. I couldn't continue Topamax b/c, for some reason, it made me Really tired. Otherwise, it did help with the mania at @250 mg. But, once I stopped, I realized how bad the cognitive effects were - that may not happen to you, may not make a difference to you if it does, but I did much better on Depakote.
>
> - K.Sher: I don't know if yours was a general post or to someone in specific but I came to Topamax via 2 hypomanic phases presumably triggered by Celexa, which I need to mitigate depression & anxiety. (Prior to Celexa I had used Serzone and then Luvox. Luvox being the better of the two.)
Thanks for sharing your information!
Kim
Posted by shersher on January 7, 2002, at 7:01:49
In reply to Re: Topamax Experiences?}}Kingfish » shersher, posted by Krazy Kat on January 6, 2002, at 15:40:15
> Sher:
>
> Thanks for your info. I couldn't continue Topamax b/c, for some reason, it made me Really tired. Otherwise, it did help with the mania at @250 mg. But, once I stopped, I realized how bad the cognitive effects were - that may not happen to you, may not make a difference to you if it does, but I did much better on Depakote.
>
> - K.Thanks
its all so hard but thanks God there is meds
sher!!!!
Posted by Bette Powers on February 6, 2002, at 17:42:46
In reply to Re: Topamax Experiences?}}Kingfish, posted by shersher on January 6, 2002, at 7:52:17
Hi, My name is Bette and I am Bipolar.....have been for years and years but only diagnozed and treated for 3 years on lithium (lithobid)1200mg) and
zoloft(100mg). Have gained 70 lbs even with dieting and exercise program.....Now a new Dr. says I should take Topamax. I am almost never deprssed...it is always a manic state I am in....
How important is it to start with such a slow, low dose?
Does anyone really lose weight?
Do you get cold sores? What else can I expect?
Also, my Dr. says take the lithium AND the topamax....has anyone heard of that?
PLEASE, PLEASE help me by writing to me....EVERYONE....it would be an act of sincere kindness if you could/would encourage me and warn me what to expect......I have not been able to work for 2 years but my disability runs out in June.....
Posted by shersher on February 7, 2002, at 9:02:24
In reply to Re: Topamax Experiences, posted by Bette Powers on February 6, 2002, at 17:42:46
> Hi, My name is Bette and I am Bipolar.....have been for years and years but only diagnozed and treated for 3 years on lithium (lithobid)1200mg) and
> zoloft(100mg). Have gained 70 lbs even with dieting and exercise program.....Now a new Dr. says I should take Topamax. I am almost never deprssed...it is always a manic state I am in....
> How important is it to start with such a slow, low dose?
> Does anyone really lose weight?
> Do you get cold sores? What else can I expect?
> Also, my Dr. says take the lithium AND the topamax....has anyone heard of that?
> PLEASE, PLEASE help me by writing to me....EVERYONE....it would be an act of sincere kindness if you could/would encourage me and warn me what to expect......I have not been able to work for 2 years but my disability runs out in June.....Hi Bette
My name is Sher and I can relate to your problem. I am bipolar too and am on topamax, lithium and zoloft. I have lost 25 lbs. in 3 mos since starting the topamax. It was tough at first with alot of side effects like tingling fingers and toes and cloudy thoughts. But I stuck with it and have been able to adjust my lithium way down. I also have lowered my zoloft from 100 to 50mg a day. Its been a rough 3 mos but I am very stable and happy with where I am now.
Hang in there and god bless your efforts....
sher
Posted by Bette Powers on February 7, 2002, at 9:54:49
In reply to Re: Topamax Experiences, posted by shersher on February 7, 2002, at 9:02:24
Dear Sher: Thanks for writing....it meant a great deal to me. Today is day#1 taking the Topamax: 25mg morning and 25 mg night.....and Lithium cut back to 300 mg daily. Hey, everyone else, I need info and encouragement...... writing to me....AND I MEAN EVERYONE....would be an act of sincere kindness -if you could/would INFORM ME, encourage me and warn me what to expect......
I have a husband who is interested only in my disability check (which ends in June) so I have no support at home. Each day I pray for all of us who suffer this affliction......please let us all offer a special prayer for Sher who answered me immeditely.
Posted by Scheherizade on February 7, 2002, at 11:01:58
In reply to Re: Topamax Experiences, posted by Bette Powers on February 6, 2002, at 17:42:46
Greetings Betty,
I have only just begun taking Topomax. I also started a thread lower on this page and JohnX2 was kind enough to respond. I am taking it in hopes that I might find some small relief for my chronic headache. Lord please! I am experiencing side affects and also looking for encouragement to muddle through it. Though I will not claim that what I am taking it for comes close to your battle. Or most of you out here. My prayers are with you all.
The LORD bless you and keep you;
The LORD make his face shine upon you and be gracious to you;
The LORD turn his face toward you and give you peace.
Posted by shersher on February 7, 2002, at 13:38:32
In reply to Re: Topamax Experiences, posted by Bette Powers on February 7, 2002, at 9:54:49
> Dear Sher: Thanks for writing....it meant a great deal to me. Today is day#1 taking the Topamax: 25mg morning and 25 mg night.....and Lithium cut back to 300 mg daily. Hey, everyone else, I need info and encouragement...... writing to me....AND I MEAN EVERYONE....would be an act of sincere kindness -if you could/would INFORM ME, encourage me and warn me what to expect......
> I have a husband who is interested only in my disability check (which ends in June) so I have no support at home. Each day I pray for all of us who suffer this affliction......please let us all offer a special prayer for Sher who answered me immeditely.Do not lose heart you are not alone... I check this fairly frequently...you may be really tired at first and cloudy..just be patient and go slowly..we are in this with you...
sher
Posted by Chrissy on February 7, 2002, at 13:51:03
In reply to Re: Topamax Experiences, posted by Bette Powers on February 7, 2002, at 9:54:49
Hello, My name is Chrissy, I'm 26 and have been dealing with depression, and more recently correctly diagnosed with bipolar since I was 19. Been on many meds. SO TIRED OF THE UP AND DOWNS OF WEIGHT GAINING! Pretty much been my own detective looking up different meds. My Doctor is cool, she's letting me try Topamax. Been on it for a month now. (Am also still on 40mg of Prozac) I'm still only taking 50mg of topomax at bedtime, I'm afraid to taper up and take more because of the drowsy side effects. But from reading the posts, people say it goes away with more, so maybe I'll just go for it!! The thing is I'm a waitress and one night at work while at a table I fealt so woosie and in like a dream state! it scared me!, other than that, I absolutely Love that it helps with my appetite!! lost 8 lbs so far! I have NO anger fits, or major emotional episodes! I'm goin to stick with this! So BETTE we'll do it together!! Only other problem I'm having is about mid-day I start feeling dull anxiety, like a guilt feeling in my chest. I just want to go lay down. Wondering if Prozac combo is doing this, anyone know? Chrissy
Posted by shersher on February 7, 2002, at 15:01:52
In reply to Re: Topamax Experiences NEW POST, posted by Chrissy on February 7, 2002, at 13:51:03
> Hello, My name is Chrissy, I'm 26 and have been dealing with depression, and more recently correctly diagnosed with bipolar since I was 19. Been on many meds. SO TIRED OF THE UP AND DOWNS OF WEIGHT GAINING! Pretty much been my own detective looking up different meds. My Doctor is cool, she's letting me try Topamax. Been on it for a month now. (Am also still on 40mg of Prozac) I'm still only taking 50mg of topomax at bedtime, I'm afraid to taper up and take more because of the drowsy side effects. But from reading the posts, people say it goes away with more, so maybe I'll just go for it!! The thing is I'm a waitress and one night at work while at a table I fealt so woosie and in like a dream state! it scared me!, other than that, I absolutely Love that it helps with my appetite!! lost 8 lbs so far! I have NO anger fits, or major emotional episodes! I'm goin to stick with this! So BETTE we'll do it together!! Only other problem I'm having is about mid-day I start feeling dull anxiety, like a guilt feeling in my chest. I just want to go lay down. Wondering if Prozac combo is doing this, anyone know? Chrissy
Chrissy,
Its sher, a month is not very long to get stabilized. I worked up to 200 mg of topamax in about a month and a half but then had to add back in my lithium so I dropped my topa down to 150. I don't take prozac but I do take zoloft partly because it has an antianxiety effect also. But you have to go slowly switching from this as well. Why don't you try upping your topa dose at bedtime after work???? or on a day off ?? Don't be scared to get stabilized...bipolar is one of the most manageable mental diseases there is once you find the right med combo for you...its just HELL figuring it out...be persistent and pray.sher
Posted by Jet on February 9, 2002, at 0:34:23
In reply to Re: Topamax Experiences, posted by Bette Powers on February 6, 2002, at 17:42:46
> Hi, My name is Bette and I am Bipolar.....have been for years and years but only diagnozed and treated for 3 years on lithium (lithobid)1200mg) and
> zoloft(100mg). Have gained 70 lbs even with dieting and exercise program.....Now a new Dr. says I should take Topamax. I am almost never deprssed...it is always a manic state I am in....
> How important is it to start with such a slow, low dose?
> Does anyone really lose weight?
> Do you get cold sores? What else can I expect?
> Also, my Dr. says take the lithium AND the topamax....has anyone heard of that?
> PLEASE, PLEASE help me by writing to me....EVERYONE....it would be an act of sincere kindness if you could/would encourage me and warn me what to expect......I have not been able to work for 2 years but my disability runs out in June.....Hello Bette:
I can only tell you my experience with Topamax. I have been on it for amost 5 months now and have lost 25 pounds. I am not taking this medication to lose weight - although my pdoc said that it happens to be a side effect. I am taking it for Bi-Polar II. At first the side effects were strange and unpleasant. My hands, feet, face and chest had a pins and needle feeling. It was weird. But since I felt "better" for the first time in 12 years, I didn't much care - plus, the side effects have calmed down now and have almost gone away. As I upped each dose, I did notice the side effects for a few days, then they would slowly fade away. I still have them a little bit. But, I am feeling better, and I just figure that the trade off for now is just worth it. I would rather be up and moving with the living than in bed wishing I was dead on my "bad" days.
It is very important to up your dose very slowly. My pdoc told me to only increase my dose by 25 mg. every 10 days. I have read on these boards that some people have had some real problems by increasing too fast. So be very careful.
You see, for the past 15 years I have tried all of the AD's there are to try and none of them have worked, so when my pdoc said, why not try this drug called Topamax - I said why not? It is working well for me at 400 mg. Although it has only been 2 weeks since I upped it to 400 - I haven't dipped yet. I have my fingers crossed!
Side effects for me have been:
Weight loss
Blurry vision occasionally
Pins & Needles on hands, feet, face, hands & chest
Aggression (at low dose but went away)
More energy
From reading this board, I have seen where people have mixed Topamax and Lithium and done fine. Do a search by typing in both Topamax and Lithium and see what you come up with. This board is amazing in how it is setup.I don't know anything about cold sores. I don't have them and actually never have had one. I hope that my story has helped you in some way. I wish you the best. Jet
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