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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by FloydAS on April 7, 2016, at 9:26:33
I'm currently taking Topamax 50 mg twice a day for migraine prevention. Initially I did lose a small amount of weight during the initial side effects of everything tasting funny and food simply being off putting. That passed and my eating habits returned to normal. I have been on Topamax for about 3 years. I have progressively gained weight and now having difficulty losing any despite watching what I eat. I have read that in some rare cases (maybe rare is too strong) that Topamax can cause a paradoxical weight gain effect in some individuals.
Complicating matters, I started Brintellix 20 mg a year ago which isn't reported to cause significant weight gain, but of course that is individual dependent.
I also had two hip arthroscopies to repair torn labrums - one in 2014 and one in late 2015 and struggling to regain normal activity levels. That being said my weight gain started before the surgeries and continued at the same rate afterward.
I'm also on Focalin XR 10 mg during weekdays for ADD concentration problems at work. Between the Focalin and Topamax the doctors figured I would experience weight loss but I have experienced the opposite.
I also take propranolol daily to control essential tremor. I've been on Propranolol the longest - probably nearing a decade now.
So with all of that background, it's very difficult to determine what's my primary cause of the weight gain since it is likely there's an inter-relationship between multiple factors. But I'm willing to remove the likely biggest contributing factor.
I plan to discuss with both my regular doctor and my pdoc within the next month but wanted the board's opinion. My initial thought was to possibly ween off the Topamax under doctor orders (if he agrees) and see if the headaches and migraines return and monitor the weight issue. Brintellix has been good to me so I really don't want to mess with it. And I'll be shaking like a 99 year old Parkinson's patient if I go off Propranolol so my options are quite limited I think.
Any thoughts? Sorry for rambling, but I appreciate any input.
Posted by Christ_empowered on April 7, 2016, at 10:39:27
In reply to Weight Gain - any thoughts on med cause?, posted by FloydAS on April 7, 2016, at 9:26:33
Hi. I dunno...topomax is kind of...too hardcore, in terms of side effects, for me...so I wish you well with the taper, most definitely.Could you increase the Focalin? I mean, its a schedule II and I don't want to advise you into some "Valley of The Dolls" style pill use, but a relative of mine did OK on 20mgs of the XR per day (until switched to equivalent Adderall). Just a thought.
I don't know much about tremor. I was on propranolol for a tremor from an "atypical" neuroleptic way back when. Turns out...they should have just lowered the dose. Can dopamine agonists be used for this? Cuz, I was thinking...if you can take one of the newer dopamine agonists for the tremor, maybe that would help your mood+concentration and have a good effect on weight, over time (?). Obviously, I'm --not-- any kinda expert, just throwing random ideas out there for you.
I hope you and your presciber(s) can come up with a good game plan.
Posted by Lamdage22 on April 7, 2016, at 10:52:44
In reply to Re: Weight Gain - any thoughts on med cause?, posted by Christ_empowered on April 7, 2016, at 10:39:27
With regular kidney function tests you could add Metformin for weight loss... (if it is ok with your other meds. Check on http://www.drugs.com )
Works for me.
Posted by FloydAS on April 7, 2016, at 11:36:35
In reply to Re: Weight Gain - any thoughts on med cause?, posted by Christ_empowered on April 7, 2016, at 10:39:27
>
> Could you increase the Focalin? I mean, its a schedule II and I don't want to advise you into some "Valley of The Dolls" style pill use, but a relative of mine did OK on 20mgs of the XR per day (until switched to equivalent Adderall). Just a thought.
>I had been on 20 mg of Focalin XR and found it to be too strong. It kicked my anxiety up way too much so my pdoc and I settled back to a 10 mg dosage which has been satisfactory.
As for the propranolol alternatives - not sure. From what I understand there's not many alternatives for essential tremor. The primary alternative is Primidone. Beyond that, the neurologist suggested Deep Brain Stimulation as a last resort if the meds fail to control the tremors and the tremors become life altering. Luckily the propranolol has been sufficient. The neurologist said the Topamax would add some support for tremor reduction but not much.
Posted by Lamdage22 on April 7, 2016, at 12:34:02
In reply to Re: Weight Gain - any thoughts on med cause? » Christ_empowered, posted by FloydAS on April 7, 2016, at 11:36:35
Beyond that, the neurologist suggested Deep Brain Stimulation as a last resort if the meds fail to control the tremors and the tremors become life altering. Luckily the propranolol has been sufficient.
Thank god. DBS is risky business to say the least.
This is the end of the thread.
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