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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 15 of 15. This is the beginning of the thread.
Posted by floatingbridge on October 10, 2011, at 13:39:50
Full text article:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120893/?tool=pmcentrez
Posted by SLS on October 10, 2011, at 14:48:24
In reply to Topiramate, potential fear extinction in PTSD, BPD, posted by floatingbridge on October 10, 2011, at 13:39:50
> Full text article:
>
> http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120893/?tool=pmcentrez
Very interesting.It should be noted that the dosage (10mg/kg body weight) of topiramate used for the experimental rats was 3 - 4 times higher that used in treating humans. I can't imagine anyone taking 800mg of topiramate and not suffering impairments in cognition and memory. What if a lower dosage (100mg) was arrived at using a very gradual titration schedule? Most people can avoid or minimize cognitive side effects when topiramate is administered this way. Would topiramate still act to squelch and reverse PTSD in rats at the lower concentrations currently used clinically to treat epilepsy in humans? I would hope that the efficacy of topiramate in preventing or reversing PTSD in humans is not dependent upon transforming someone into a blithering idiot.
- Scott
Posted by floatingbridge on October 10, 2011, at 15:02:41
In reply to Re: Topiramate, potential fear extinction in PTSD, BPD » floatingbridge, posted by SLS on October 10, 2011, at 14:48:24
My basic math skills are pretty rusty. Good point.
Here is a link to the Harvard Journal of a recent update to the South Shore Project's treatment algorithm for PTSD that mentions topiramate for use in treating reoccurring memory.
http://lib.bioinfo.pl/auid:4144236
They do not mention dosages.
Posted by floatingbridge on October 10, 2011, at 15:33:15
In reply to Re: Topiramate, potential fear extinction in PTSD, BPD » floatingbridge, posted by SLS on October 10, 2011, at 14:48:24
Looks like real world dosing is 175mg average within a range of 25mg to 500mg. Don't know how the average is calculated.
So 100mg 'may not' reduce cognitive functioning too greatly? (Yes, ymmv.). I will remember your note about the gradual titration if it ever come to it.
Because, I gotta say, something that might work with consolidated memory sounds good to me. Would be a boon
to reconditioning maladaptive thought and behavior.> Very interesting.
>
> It should be noted that the dosage (10mg/kg body weight) of topiramate used for the experimental rats was 3 - 4 times higher that used in treating humans. I can't imagine anyone taking 800mg of topiramate and not suffering impairments in cognition and memory. What if a lower dosage (100mg) was arrived at using a very gradual titration schedule? Most people can avoid or minimize cognitive side effects when topiramate is administered this way. Would topiramate still act to squelch and reverse PTSD in rats at the lower concentrations currently used clinically to treat epilepsy in humans? I would hope that the efficacy of topiramate in preventing or reversing PTSD in humans is not dependent upon transforming someone into a blithering idiot.
>
>
> - Scott
Posted by creepy on October 10, 2011, at 17:15:40
In reply to Topiramate, potential fear extinction in PTSD, BPD, posted by floatingbridge on October 10, 2011, at 13:39:50
It worked really well on some of my PTSD symptoms.
Some research paper hypothesized it slows the amygdala where the hyperarousal begins.
Posted by Phillipa on October 10, 2011, at 17:48:46
In reply to Re: Topiramate, potential fear extinction in PTSD, BPD, posted by creepy on October 10, 2011, at 17:15:40
Can you take with Maoi? Phillipa
Posted by floatingbridge on October 10, 2011, at 18:33:37
In reply to Re: Topiramate, potential fear extinction in PTSD, BPD, posted by creepy on October 10, 2011, at 17:15:40
Creepy, did it mess with your cognition?
You write helped as in past tense. No more?
What symptoms did it improve (if I may ask)?
Posted by floatingbridge on October 10, 2011, at 18:38:06
In reply to Re: Topiramate, potential fear extinction in PTSD, BPD, posted by Phillipa on October 10, 2011, at 17:48:46
Hi Phillipa, yes. I see my doc in about 10 days and will discuss possibilities then. First I am settling into Emsam increase. Still reading about topiramate. It is also used off label for fibromyalgia pain.
Posted by creepy on October 10, 2011, at 19:39:38
In reply to Re: Topiramate, potential fear extinction in PTSD, BPD » creepy, posted by floatingbridge on October 10, 2011, at 18:33:37
It was good on pain, hyperarousal and maybe a little on anxiety in general. I couldnt get over 50mg since I started to rapid cycle and I got really clumsy and stupid on it.
I might have done ok on it if Id given it a chance but I cant afford to lose my job to side effects =(
Posted by floatingbridge on October 10, 2011, at 20:43:02
In reply to Re: Topiramate, potential fear extinction in PTSD, BPD, posted by creepy on October 10, 2011, at 19:39:38
Creepy, that doesn't sound so good. Rapid cycling, too?
I think help with hyperarosal would be good. Have you found anything to help with that long term?
Risperdone at a low dose has helped me some.... Don't know if you have tried that.
Thanks.
Posted by Phillipa on October 10, 2011, at 21:18:17
In reply to Re: Topiramate, potential fear extinction in PTSD, BPD » Phillipa, posted by floatingbridge on October 10, 2011, at 18:38:06
Give it time. No need to jump from med to med. Didn't you call the doc? Love Phillipa
Posted by floatingbridge on October 10, 2011, at 21:33:49
In reply to Re: Topiramate, potential fear extinction in PTSD, BPD » floatingbridge, posted by Phillipa on October 10, 2011, at 21:18:17
Thanks Phillipa. I see my doc in about ten days. We can talk about it then. For now, I have a call out asking to go back to 600mg gabapentin.
Posted by sigismund on October 11, 2011, at 2:34:36
In reply to Re: Topiramate, potential fear extinction in PTSD, BPD, posted by creepy on October 10, 2011, at 17:15:40
Years ago Firebreather on the Alternative Board said he had gained excellent results with the hottest chillies around and even pure capsaican crystals for just this purpose through just this mechanism.
I was not convinced it would be worth it.
Posted by creepy on October 11, 2011, at 13:00:33
In reply to Re: Topiramate, potential fear extinction in PTSD, BPD » creepy, posted by floatingbridge on October 10, 2011, at 20:43:02
My symptoms arent severe enough to warrant using an AAP.
When I get into a period when its a problem I can usually get by using supplements like holy basil and kava kava.
Posted by floatingbridge on October 11, 2011, at 13:34:51
In reply to Re: Topiramate, potential fear extinction in PTSD, BPD, posted by creepy on October 11, 2011, at 13:00:33
Well it's good to hear that you have found some good herbals.
I have found some pain relief recently with herbal/supplement combos, and that has been encouraging.
But I am also decreasing my benzo load.... Maybe in the future herbals will be more effective for me in the areas of anxiety and reactivity.
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