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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Greg on August 19, 2001, at 13:01:09
My psych started me on Topamax about 4 days ago (25mgs, 2x) for mood stabilization. He said I may experience some cognitive dulling and fatigue, both which should pass with time. I haven't experineced either so far, but I am on a low dose. I have noticed that my anxiety is not as bad and that I'm sleeping thru the night without waking, both good things. We will be raising it slowly until I am at 100mgs, 2x.
Has anyone got experience with this med, bad or good that they could share with me? I also take Zyprexa 2.5mgs at bedtime, and Xanax .5mgs as needed.
Thanks,
Greg
Posted by akc on August 19, 2001, at 17:18:53
In reply to Topamax?, posted by Greg on August 19, 2001, at 13:01:09
I have been on Topamax for a little over 2 months -- currently taking 75 mg, 2x per day. I had a really bad depressed episode a couple of weeks ago -- not triggered by the topamax, but it does prevent me from saying exactly how I am benefitting from the topamax at the moment. I did think I was doing pretty well, until the crash (fyi, my pdoc thinks I crashed because I went of the lithium, what I had hoped the topamax would replace -- now it may be that topamax will augment, I don't know).
I am glad you are reporting no side effects at this time. I write mainly to offer one piece of advice. Go up very, very slowly on this med. The drug company is still saying 50 mg per week, but everything I have read on this site and others, and based on my own experience, would suggest that you should go no faster than 25 mg a week. Even at that rate, I did have a little bit of cognitive dulling. You will know when it hits you. I couldn't hardly add 2 plus 2. It didn't last more than a couple of days after an increase -- and only happened a few times.
I also had some problems with the pins and needles sensation. It was never really that bad -- I rarely get it now (once or twice a week).
I'll say it again -- don't let your doctor raise it more than 25 mg a week. Even at that speed, some people have found it to be too quick.
Hope this helps.
akc
Posted by chloe on August 19, 2001, at 17:37:16
In reply to Topamax?, posted by Greg on August 19, 2001, at 13:01:09
I was on a low dose of topamax for a week. With each passing day, I grew more and more anxious, with tingling in my hands/feet and my hair and skin getting amazingly dry, sore and flaky. When I did increase the dose, in hopes of an improvement in anxiety, it was only compounded.
So I discontinued it.I am so glad you are having a good result so far. But as akc said, do increase the dose slowly. The side effects can seek up on you!
You asked for the good and the BAD. My experience was bad! Good luck!
Chloe
Posted by Kingfish on August 21, 2001, at 8:35:44
In reply to Topamax?, posted by Greg on August 19, 2001, at 13:01:09
Greg:
Sorry to repeat what you've already heard, but the key does seem to be how slowly you titrate up. I went up too quickly, I think 50 mg a week, and the cognitive affects were very obvious. It was as if I were drunk - I slurred and veered from side to side when walking. And I couldn't find words.
These side effects went away once I got to my current dose of 250 mg, after about 4 weeks of being there. I also had the tingling sensations for awhile, but these really didn't both me.
Topamax did help me with ruminating thoughts and it helped me think more linearly. Helped me make decisions. It doesn't seem to be helping with mania, though, so I am going on Depakote soon, and possibly off Topamax - don't know yet.
I did have some continuing trouble with sedation from Topamax, but I haven't heard that from anyone else.
Good luck.
- K.
Posted by Greg on August 22, 2001, at 10:17:59
In reply to Re: Topamax?, posted by Kingfish on August 21, 2001, at 8:35:44
Just so that I'm clear on this, were your increases 25mgs per dose, or per day? My current schedule is 25mgs per dose and then 50mgs per dose. I'm at 25mgs am and 25 pm now, then I go to 50 and 50 for a week and then to 100 and 100 thereafter. It sounds like you both think that's to rapid an increase from your experience and I'd like to discuss that with my doc if that's the case.
Thanks so much for the feedback (you too Chloe, yes I do want bad and good results).
I hope everyone is well,
Greg> Greg:
>
> Sorry to repeat what you've already heard, but the key does seem to be how slowly you titrate up. I went up too quickly, I think 50 mg a week, and the cognitive affects were very obvious. It was as if I were drunk - I slurred and veered from side to side when walking. And I couldn't find words.
>
> These side effects went away once I got to my current dose of 250 mg, after about 4 weeks of being there. I also had the tingling sensations for awhile, but these really didn't both me.
>
> Topamax did help me with ruminating thoughts and it helped me think more linearly. Helped me make decisions. It doesn't seem to be helping with mania, though, so I am going on Depakote soon, and possibly off Topamax - don't know yet.
>
> I did have some continuing trouble with sedation from Topamax, but I haven't heard that from anyone else.
>
> Good luck.
>
> - K.
Posted by akc on August 22, 2001, at 14:22:34
In reply to Re: Topamax? AKC, Kingfish, posted by Greg on August 22, 2001, at 10:17:59
Yes, I think your increase is too rapid. My increase was 25mg per day. Going up 50mg in a day is risky, but when you go up by 100 mg, I won't be surprised if you have some pretty significant side effects.
It took a long time to get to my current dose of 75 mg twice a day (I started at 25 mg twice a day), but I think it was well worth the wait -- my side effects were minimal. I would increase the evening dose one week (e.g., 25 mg in the morning, 50 mg in the evening) then the next week increase the morning does (50 mg twice a day).
If you start experiencing the side effects, you can always back off and talk to your doctor.
AKC
> Just so that I'm clear on this, were your increases 25mgs per dose, or per day? My current schedule is 25mgs per dose and then 50mgs per dose. I'm at 25mgs am and 25 pm now, then I go to 50 and 50 for a week and then to 100 and 100 thereafter. It sounds like you both think that's to rapid an increase from your experience and I'd like to discuss that with my doc if that's the case.
>
> Thanks so much for the feedback (you too Chloe, yes I do want bad and good results).
>
> I hope everyone is well,
> Greg
>
> > Greg:
> >
> > Sorry to repeat what you've already heard, but the key does seem to be how slowly you titrate up. I went up too quickly, I think 50 mg a week, and the cognitive affects were very obvious. It was as if I were drunk - I slurred and veered from side to side when walking. And I couldn't find words.
> >
> > These side effects went away once I got to my current dose of 250 mg, after about 4 weeks of being there. I also had the tingling sensations for awhile, but these really didn't both me.
> >
> > Topamax did help me with ruminating thoughts and it helped me think more linearly. Helped me make decisions. It doesn't seem to be helping with mania, though, so I am going on Depakote soon, and possibly off Topamax - don't know yet.
> >
> > I did have some continuing trouble with sedation from Topamax, but I haven't heard that from anyone else.
> >
> > Good luck.
> >
> > - K.
This is the end of the thread.
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