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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 16 of 16. This is the beginning of the thread.
Posted by Elzabeth on July 26, 2001, at 23:40:00
My search for relief from emotional pain has seen me through a kaleidoscope of confusion, to say the least. Although there isn't a lot of clarity on this, it seems bipolar issues run in the family, but I'm also an incest survivor, so there's been accompanying confusion as to whether my problems stemmed from this, or linked back to genetics. Whatever the origin, I've tried 11 different medications to-date. About a year ago I switched to Serzone for depression, and today I saw a new M.D. who suggested Topamax might be the ticket for stabilizing anxiety and other sort of high-end clatter and stress. (My words, not his.) Here's hoping it works. I'm so tired of this pain. I'm also so relieved to have found this little group. Finally, I feel I'm among people who speak the same language. I'll let you know how things unfold. Here's wishing you all the best from my heart to yours.
Posted by SalArmy4me on July 26, 2001, at 23:47:23
In reply to Topamax: Something New, posted by Elzabeth on July 26, 2001, at 23:40:00
KUPKA, RALPH W. The Stanley Foundation Bipolar Depression Network: 2. Preliminary summary of demographics, course of illness and response to novel treatments+. British Journal of Psychiatry. 178 SUPPLEMENT 41:s177-s183, June 2001:
"Of the 54 patients treated with topiramate, 30 were in a manic, hypomanic, mixed or extremely rapid cycling state, 11 were depressed and 13 were relatively euthymic. The euthymic patients received topiramate for psychotropic drug-induced weight gain and/or binge eating, since this drug has shown anorectic and weight-loss effects in clinical trials in patients with epilepsy. Significant improvement of manic symptomatology was seen in the first subgroup (patients who were initially in a manic, hypomanic, mixed or rapid cycling state), with 63% rated as responders after 10 weeks, while only 27% of the depressed group showed much improvement in their depressive symptoms. The group of euthymic patients showed no significant changes in mood ratings. On the average there was a significant reduction of weight (down 4.9%) and body mass index (down 5.0%) in the whole group of patients..."
Posted by v on July 27, 2001, at 6:17:28
In reply to Topamax: Something New, posted by Elzabeth on July 26, 2001, at 23:40:00
hello elizabeth... i just wanted say hello as i come from a similar background (you end up having to deal with PTSD ... and i also have DID issues as well as eating disorders) and yes, it is very hard for me to separate my biochemical imbalances from my "experiences" but i figure that's only contributed to the imbalance... either way, i've got both issues to deal with as well... and sometimes i think they definitely get in the way of each other
as far as topomax goes, i think it often carries a side effect of cognitive impairment... you might want to do some research on it as well as other drugs like it
i don't know what drugs you've tried but i'm currently on a cocktail of concerta, wellbutrin & klonopin...(i'm also weaning myself off effexor... what fun) and i've discussed adding neurontin to the mix next month...
good luck and welcome!
v> My search for relief from emotional pain has seen me through a kaleidoscope of confusion, to say the least. Although there isn't a lot of clarity on this, it seems bipolar issues run in the family, but I'm also an incest survivor, so there's been accompanying confusion as to whether my problems stemmed from this, or linked back to genetics. Whatever the origin, I've tried 11 different medications to-date. About a year ago I switched to Serzone for depression, and today I saw a new M.D. who suggested Topamax might be the ticket for stabilizing anxiety and other sort of high-end clatter and stress. (My words, not his.) Here's hoping it works. I'm so tired of this pain. I'm also so relieved to have found this little group. Finally, I feel I'm among people who speak the same language. I'll let you know how things unfold. Here's wishing you all the best from my heart to yours.
Posted by kid47 on July 27, 2001, at 12:06:39
In reply to Re: Topamax: Something New » Elzabeth, posted by v on July 27, 2001, at 6:17:28
Hi. I was on Topomax as well as Neurontin. Didn't notice the "dumbing" fx (I was already pretty stupid to begin with=P) but have heard from some who have. After a med free 3mos. (was taking FXR, Topomax, Neurontin, Klonopin) I am just starting Wellbutrin SR 150mg & Klonopin. I enjoy the energizing fx of the Wellb but have had to take considerable (for me) Klonopin to fight off anxiety/panic. I have also been experiencing some rapid cycling (BP II) I too am thinking of adding Neurontin back into the mix. At one point I was taking 3200mg (800x4) with no side fx & it seemed to have a calming & stabilizing effect for me. I would be interested to know if the Neurontin works out for you. Take care
kid
> hello elizabeth... i just wanted say hello as i come from a similar background (you end up having to deal with PTSD ... and i also have DID issues as well as eating disorders) and yes, it is very hard for me to separate my biochemical imbalances from my "experiences" but i figure that's only contributed to the imbalance... either way, i've got both issues to deal with as well... and sometimes i think they definitely get in the way of each other
>
> as far as topomax goes, i think it often carries a side effect of cognitive impairment... you might want to do some research on it as well as other drugs like it
>
> i don't know what drugs you've tried but i'm currently on a cocktail of concerta, wellbutrin & klonopin...(i'm also weaning myself off effexor... what fun) and i've discussed adding neurontin to the mix next month...
>
> good luck and welcome!
> v
>
> > My search for relief from emotional pain has seen me through a kaleidoscope of confusion, to say the least. Although there isn't a lot of clarity on this, it seems bipolar issues run in the family, but I'm also an incest survivor, so there's been accompanying confusion as to whether my problems stemmed from this, or linked back to genetics. Whatever the origin, I've tried 11 different medications to-date. About a year ago I switched to Serzone for depression, and today I saw a new M.D. who suggested Topamax might be the ticket for stabilizing anxiety and other sort of high-end clatter and stress. (My words, not his.) Here's hoping it works. I'm so tired of this pain. I'm also so relieved to have found this little group. Finally, I feel I'm among people who speak the same language. I'll let you know how things unfold. Here's wishing you all the best from my heart to yours.
Posted by AKC on July 27, 2001, at 12:43:42
In reply to Topamax: Something New, posted by Elzabeth on July 26, 2001, at 23:40:00
Elzabeth,
I have been on Topamax for 6 weeks now (now on 175 mg - heading for goal of 200 mg). For me it has been an absolute miracle drug. I have had some periods of cognitive dulling after each increase, but that has passed each time after a few days. I also take Effexor XR and seroquel. My doctor is attempting to cut back my Effexor.
I hope you have the success I have had on topamax.
AKC
Posted by MB on July 27, 2001, at 16:28:54
In reply to Topamax: Something New, posted by Elzabeth on July 26, 2001, at 23:40:00
Elizabeth--I really hope this helps you out. I've enjoyed what limited correspondence we've engaged in, and I think you are a neat person. I really hope this is the ticket for you (or part of the ticket..or whatever). I'll keep my fingers crossed for you. Good luck.
Peace.
Posted by Maung on July 28, 2001, at 8:14:56
In reply to Topamax: Something New, posted by Elzabeth on July 26, 2001, at 23:40:00
> My search for relief from emotional pain has seen me through a kaleidoscope of confusion, to say the least. Although there isn't a lot of clarity on this, it seems bipolar issues run in the family, but I'm also an incest survivor, so there's been accompanying confusion as to whether my problems stemmed from this, or linked back to genetics. Whatever the origin, I've tried 11 different medications to-date. About a year ago I switched to Serzone for depression, and today I saw a new M.D. who suggested Topamax might be the ticket for stabilizing anxiety and other sort of high-end clatter and stress. (My words, not his.) Here's hoping it works. I'm so tired of this pain. I'm also so relieved to have found this little group. Finally, I feel I'm among people who speak the same language. I'll let you know how things unfold. Here's wishing you all the best from my heart to yours.
Elizabeth, I've been on Topomax since 1999 and GRADUALLY worked up to a dose of 250mg...I also take 1200 mg of Neurontin...I am diagnosed as BP II, rapid cyling. I am an attorney (not presently practicing) who will be returning to school for an LLM in the fall (part-time)...I don't think I would be returning to school if it weren't for Topomax. I have found topomax to be very helpful...not so much for anxiety; Neurontin is useful for that...the topomax does more to quiet my mind. Studies have also shown Topomax to be helpful for post traumatic stress syndrome survivors (I'm sorry I don't have the site for this but I have seen it on Ivan Goldberg's Depression Central and on Medscape if you care to run a search). I do not experience any cognitive side effects on topomax provided I go up on the dosage very slowly..if I notice problems, I simply drop the dose and the problems disappear immediately. I hope you find Topomax to be as helpful to you as I have found it for me. Sincerely...Sue (Maung is really Sue)
Posted by Elzabeth on July 29, 2001, at 0:31:22
In reply to Re: Topamax: Something New » Elzabeth, posted by Maung on July 28, 2001, at 8:14:56
Dear Ones ~ thank you and bless you for writing. It means a great deal, and I hope to find relief from Topamax, although lately, I've been so depressed, I'm wondering if I don't need more picking up on the bottom end (in addition to assistance with that top-end stress). This weekend was my 30th high school reunion. Ugh. I survived. Guess I won't need to do THAT again for another 30 years .... Anyhow, I delayed starting this new Rx so I could have a well-needed drink .... Plan to start my trial in the a.m. My dose starts at 25 mg/twice daily for a week. Then it increases to 100 mg daily for a week, and finally 200 mg. daily (therapeutic range?) I'll let you know how it goes. I especially appreciate the input I've received on cognitive effects, as I can't bare to have my mental powers diminished any greater than what I suffer already -- pushing 50. Good Lord. We all need the best intellectual grasp we can find, to assist this often arduous task of living with depression. Thank you all again for writing. By the way, I'm still a bit unfamiliar with how to post things here .... Here's hoping this works. XXX, E.
Posted by jojo on July 29, 2001, at 2:01:38
In reply to Re: Topamax: Something New » Elzabeth, posted by MB on July 27, 2001, at 16:28:54
> Elizabeth--I really hope this helps you out. I've enjoyed what limited correspondence we've engaged in, and I think you are a neat person. I really hope this is the ticket for you (or part of the ticket..or whatever). I'll keep my fingers crossed for you. Good luck.
>
> Peace.Does this mean you've given up om buprenorphine?
jojo
Posted by Mitch on July 29, 2001, at 14:24:06
In reply to Re: Topamax: Something New, posted by Elzabeth on July 29, 2001, at 0:31:22
> Dear Ones ~ thank you and bless you for writing. It means a great deal, and I hope to find relief from Topamax, although lately, I've been so depressed, I'm wondering if I don't need more picking up on the bottom end (in addition to assistance with that top-end stress). This weekend was my 30th high school reunion. Ugh. I survived. Guess I won't need to do THAT again for another 30 years .... Anyhow, I delayed starting this new Rx so I could have a well-needed drink .... Plan to start my trial in the a.m. My dose starts at 25 mg/twice daily for a week. Then it increases to 100 mg daily for a week, and finally 200 mg. daily (therapeutic range?) I'll let you know how it goes. I especially appreciate the input I've received on cognitive effects, as I can't bare to have my mental powers diminished any greater than what I suffer already -- pushing 50. Good Lord. We all need the best intellectual grasp we can find, to assist this often arduous task of living with depression. Thank you all again for writing. By the way, I'm still a bit unfamiliar with how to post things here .... Here's hoping this works. XXX, E.
Elzabeth,
I found an article on medscape that recommends very slow dose increase with Topamax and from I read that has been incorporated into the PDR insert. Here is a snippet from that article:
.....Since the publication of the article entitled, "Treatment of Epilepsy in the New Millennium," several important dosing titration schedule changes have been recommended. Clinicians should be alerted to these dosing changes in order to treat patients with epilepsy optimally and safely.
As previously noted topiramate has been associated with cognitive and behavioral symptoms, along with other neurotoxicities, during titration and with high dosages. For this reason, the manufacturer (Ortho McNeil Pharmaceutical, Inc.) recommended a new titration schedule, which is now part of the prescribing information. Therapy should be started at 25-50 mg/day and titrated to an effective dosage in increments of 25-50 mg/week. Starting at lower dosages may make a substantial difference in some patients with regard to neurotoxicity. In children, titration should begin at 0.5 mg/kg/day instead of 1 mg/kg/day and increased by this same amount (0.5 mg/kg/day) at weekly intervals. More rapid titration does not produce life-threatening side effects, but it rather significantly increases the potential for neurotoxic side effects in some patients. Improved tolerability with slower titration was demonstrated in a long-term treatment protocol.
Posted by Elizabeth on July 29, 2001, at 15:05:52
In reply to Re: Topamax: Something New, posted by jojo on July 29, 2001, at 2:01:38
> Does this mean you've given up om buprenorphine?
No. I'm still taking it, but I've been able to lower the dose substantially. My hope is that I will be able to stop taking it regularly, though, because the side effects are difficult to deal with day to day.
-elizabeth
Posted by Dr. Bob on July 30, 2001, at 3:05:37
In reply to Re: Topamax: Something New » jojo, posted by Elizabeth on July 29, 2001, at 15:05:52
> > Does this mean you've given up om buprenorphine?
>
> No. I'm still taking it...It was Elzabeth who started this thread, not Elizabeth... :-)
Bob
Posted by Milda on July 30, 2001, at 5:10:27
In reply to Re: Topamax: Something New, posted by Elzabeth on July 29, 2001, at 0:31:22
I started taking Topamax in May, for mania, and it has helped me. I'm now up to 100 mg. twice a day, but I started at 25 mg. once a day, and added 25 mg. something like every six days. If you go faster than that, I believe there is more risk of getting the dreaded "brain fog" side effect.
Posted by shelliR on July 30, 2001, at 10:31:27
In reply to Re: similar names, posted by Dr. Bob on July 30, 2001, at 3:05:37
> > > Does this mean you've given up om buprenorphine?
> >
> > No. I'm still taking it...
>
> It was Elzabeth who started this thread, not Elizabeth... :-)
>
> BobElzabeth, is it possible to alter your name, like add a number or initial before or after, because it is so
close to Elizabeth (a very frequent poster), that it is very confusingshelli
Posted by AKC on July 30, 2001, at 11:17:34
In reply to Re: similar names, posted by shelliR on July 30, 2001, at 10:31:27
Queen Elzabeth II < grin >
Posted by Elizabeth on July 30, 2001, at 16:36:29
In reply to Re: similar names, posted by Dr. Bob on July 30, 2001, at 3:05:37
> > > Does this mean you've given up om buprenorphine?
> >
> > No. I'm still taking it...
>
> It was Elzabeth who started this thread, not Elizabeth... :-)Aha. < g >
-elizabeth "with an i"
This is the end of the thread.
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