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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by JohnX2 on December 8, 2001, at 17:19:10
Bailing short term on Zanaflex..too annoying
dosing schedule.Starting Topomax on top of my Lamictal and
Klonopin and Zyprexa.Topomax from what I read increases GabaA Cl-
conductance which is basically how meds like
diazepam and klonopin work. So maybe this is
the right add on to Lamictal. Also modulates
the AMPA glutamate receptor.I've gained enough weight on Zyprexa to the
point that it is worrying me. Usually I don't
mind a little weight gain, but its getting to
the point of requiring a close resizing.
Anyways Topomax is supposted to kill my appetite
so maybe that will cancel out.Wish me luck.
Anyone out there try the Topomax + Lamictal duo?
-john
Posted by JohnX2 on December 8, 2001, at 20:24:39
In reply to starting Topomax, posted by JohnX2 on December 8, 2001, at 17:19:10
Well my 1st Topomax dosing is going awesome, although
I bumped the dose because it seemed to not be
doing anything at 1st. Much better than Zanaflex.
Seems to potentiate the Klonopin with pretty
much the same side effects (a little drowsiness)
and benefits. My myofacial pain is completely alleviated
and my cognition is not substantially impaired.-john
>
> Bailing short term on Zanaflex..too annoying
> dosing schedule.
>
> Starting Topomax on top of my Lamictal and
> Klonopin and Zyprexa.
>
> Topomax from what I read increases GabaA Cl-
> conductance which is basically how meds like
> diazepam and klonopin work. So maybe this is
> the right add on to Lamictal. Also modulates
> the AMPA glutamate receptor.
>
> I've gained enough weight on Zyprexa to the
> point that it is worrying me. Usually I don't
> mind a little weight gain, but its getting to
> the point of requiring a close resizing.
> Anyways Topomax is supposted to kill my appetite
> so maybe that will cancel out.
>
> Wish me luck.
>
> Anyone out there try the Topomax + Lamictal duo?
>
> -john
Posted by JohnX2 on December 9, 2001, at 19:41:13
In reply to Re: starting Topomax, posted by JohnX2 on December 8, 2001, at 20:24:39
Well this has been nothing short of what
I would call a miracle. If someone handed
me topomax and told me it was klonopin I
wouldn't be able to tell that he was lying.
The only side effect I have has is sedation.
Plus, this is the first anti-convulsant
besides Klonopin to completely
releive my myofacial pain. Almost all the other
anti convulsants has at least some side effects
of stupor, loss of speech, incordination, blurry
vision. But not topomax. Just sedation. Identical
to my Klonopin response!I've even challenged it with a strong dose of
Wellbutrin which normally would severly exacerbate
my myofacial pain, and it beats the challenge
(no pain in face). Klonopin couldn't do this, so
I suspect Topomax's AMPA action is helping out
somehow. This opens the door for antidepressant
trials I normally couldn't try. I'm now wondering
if my short lived hypomanic anti-depressant
responses were some sort of kindled seizures.
Possibly the topomax + lamictal alone will be enough of
an anti-depressant according to my pdoc.I wonder how much of this has to do with synergy
with the Lamictal....-John
>
> Well my 1st Topomax dosing is going awesome, although
> I bumped the dose because it seemed to not be
> doing anything at 1st. Much better than Zanaflex.
> Seems to potentiate the Klonopin with pretty
> much the same side effects (a little drowsiness)
> and benefits. My myofacial pain is completely alleviated
> and my cognition is not substantially impaired.
>
> -john
>
> >
> > Bailing short term on Zanaflex..too annoying
> > dosing schedule.
> >
> > Starting Topomax on top of my Lamictal and
> > Klonopin and Zyprexa.
> >
> > Topomax from what I read increases GabaA Cl-
> > conductance which is basically how meds like
> > diazepam and klonopin work. So maybe this is
> > the right add on to Lamictal. Also modulates
> > the AMPA glutamate receptor.
> >
> > I've gained enough weight on Zyprexa to the
> > point that it is worrying me. Usually I don't
> > mind a little weight gain, but its getting to
> > the point of requiring a close resizing.
> > Anyways Topomax is supposted to kill my appetite
> > so maybe that will cancel out.
> >
> > Wish me luck.
> >
> > Anyone out there try the Topomax + Lamictal duo?
> >
> > -john
Posted by JohnX2 on December 9, 2001, at 19:48:39
In reply to Re: starting Topomax - Update, posted by JohnX2 on December 9, 2001, at 19:41:13
Posted by jazzdog on December 11, 2001, at 11:48:52
In reply to starting Topomax, posted by JohnX2 on December 8, 2001, at 17:19:10
Hi John -
Topamax is pretty interesting to me, especially in conjunction with Lamictal and Zoloft. How does it manage to be both sedating and weight-loss promoting? I thought only activating drugs sped up the metabolism enough to cause weight loss. Also, are you experiencing any cognitive dulling? A lot of people seem to complain about it, and god knows my brain is already dulled enough. Good news about the facial pain - any theories why it's working?
- Jane
Posted by JohnX2 on December 11, 2001, at 12:26:31
In reply to Re: starting Topomax » JohnX2, posted by jazzdog on December 11, 2001, at 11:48:52
Jane,The only reason I can think that topomax is
curing my myofacial pain is that one of its mode
of anti-convulsant action is similiar to klonopin's
mode on anti-convulsant action. I read this in an
article which compared topamax to diazepam.
Basically there are 2 types of Gaba neurons, GabaA
and GabaB, an elelectrolyle chlorine is negatively
charged and is passed through the neuron to inhibit
the conductance of the receiver of the neuron.
Both Klonopin and Topomax increase CL- (chlorine)
conductance in the GabaA type neuron. Other meds
like Depakote works on the GabaB type neuron.
Other anti-convulsants try to prevent the break
down of gaba instead of trying to enhance the working
of gaba. I'd explain neurologically why I think
stimulating GabaA neurons is good (as well as blocking
serotonin 5ht-2a neurons or noradrenaline alpha-1
neurons) but it is rather involved. The net
result in my case is increased dopamine in
an are of my brain where dopamine inhibits
acetycholine stimulation of muscle contraction
of jaw/head muscle contraction.At least that's MY theory,
and my response to a wide variety
of meds is consistent to it.meds that relieve my pain:
anticholinergics: benadryl,chlorphenramine
dopaminergic:Adderall,
5ht-2 antagonist:Zyprexa,Serzone
GabaA:Klonopin,Topomax.Why I don't get the other side effect typical to
anti-convulsants is a bit of a mystery. Usually
the anti-convulsants make me stuporous,slurred speech, and give me
blurry vision, Topomax just givems me the same
side effects as Klonopin, which is a slight sedation.
Topamax also modulates gluatamate at the AMPA
receptors and Lamictal modulates gluatmate at
the NMDA receptors. ITS POSSIBLE (just a hypothesis),
that some sort of interaction with lamictal actually
stabilizes the Topmax (kinda like a mood stabilizer,
right...twilight zone...).Anyways, at the GabaA receptor I would only expect
sides effects like the benzos, but at the AMPA I
might expect side effects like the other
anti-convulsants. Just my 10 cents.-john
> Hi John -
>
> Topamax is pretty interesting to me, especially in conjunction with Lamictal and Zoloft. How does it manage to be both sedating and weight-loss promoting? I thought only activating drugs sped up the metabolism enough to cause weight loss. Also, are you experiencing any cognitive dulling? A lot of people seem to complain about it, and god knows my brain is already dulled enough. Good news about the facial pain - any theories why it's working?
>
> - Jane
Posted by JohnX2 on December 11, 2001, at 12:32:19
In reply to Re: starting Topomax » jazzdog, posted by JohnX2 on December 11, 2001, at 12:26:31
Hi Jane,
I forgot to answer your weight loss question.
It doesn't seem to make me feel "full" or
"nauseaus" like stimulants or Wellbutrin.I just don't ever feel hungry. So I don't think
it is speeding up my metabalism. Why I don't
ever feel hungy is a mystery that the doctor's
can't explain. I still can enjoy food. And if
I eat too much, then my stomach does send me
a "full" signal.What were you referring too WRT to zoloft?
-John
>
> Jane,
>
> The only reason I can think that topomax is
> curing my myofacial pain is that one of its mode
> of anti-convulsant action is similiar to klonopin's
> mode on anti-convulsant action. I read this in an
> article which compared topamax to diazepam.
> Basically there are 2 types of Gaba neurons, GabaA
> and GabaB, an elelectrolyle chlorine is negatively
> charged and is passed through the neuron to inhibit
> the conductance of the receiver of the neuron.
> Both Klonopin and Topomax increase CL- (chlorine)
> conductance in the GabaA type neuron. Other meds
> like Depakote works on the GabaB type neuron.
> Other anti-convulsants try to prevent the break
> down of gaba instead of trying to enhance the working
> of gaba. I'd explain neurologically why I think
> stimulating GabaA neurons is good (as well as blocking
> serotonin 5ht-2a neurons or noradrenaline alpha-1
> neurons) but it is rather involved. The net
> result in my case is increased dopamine in
> an are of my brain where dopamine inhibits
> acetycholine stimulation of muscle contraction
> of jaw/head muscle contraction.
>
> At least that's MY theory,
> and my response to a wide variety
> of meds is consistent to it.
>
> meds that relieve my pain:
>
> anticholinergics: benadryl,chlorphenramine
> dopaminergic:Adderall,
> 5ht-2 antagonist:Zyprexa,Serzone
> GabaA:Klonopin,Topomax.
>
> Why I don't get the other side effect typical to
> anti-convulsants is a bit of a mystery. Usually
> the anti-convulsants make me stuporous,slurred speech, and give me
> blurry vision, Topomax just givems me the same
> side effects as Klonopin, which is a slight sedation.
> Topamax also modulates gluatamate at the AMPA
> receptors and Lamictal modulates gluatmate at
> the NMDA receptors. ITS POSSIBLE (just a hypothesis),
> that some sort of interaction with lamictal actually
> stabilizes the Topmax (kinda like a mood stabilizer,
> right...twilight zone...).
>
> Anyways, at the GabaA receptor I would only expect
> sides effects like the benzos, but at the AMPA I
> might expect side effects like the other
> anti-convulsants. Just my 10 cents.
>
> -john
>
>
>
>
>
> > Hi John -
> >
> > Topamax is pretty interesting to me, especially in conjunction with Lamictal and Zoloft. How does it manage to be both sedating and weight-loss promoting? I thought only activating drugs sped up the metabolism enough to cause weight loss. Also, are you experiencing any cognitive dulling? A lot of people seem to complain about it, and god knows my brain is already dulled enough. Good news about the facial pain - any theories why it's working?
> >
> > - Jane
Posted by jazzdog on December 11, 2001, at 17:07:26
In reply to Re: starting Topomax » JohnX2, posted by JohnX2 on December 11, 2001, at 12:32:19
Hi John -
Thanks for that comprehensive reply. I was thinking of Topamax mainly to counterbalance the bruxism that Zoloft worsens and the weight gain that I'm experiencing with both lamictal and zoloft. Also, some people with depersonalization have success with an ssri/lamictal/klonapin combo, but as a recovering benzo addict, I'm wary of the klonipin (yes, I know, the long half-life renders it less addictive, but still). So I wondered if topamax could substitute. However, it's still early days on the lamictal - only up to 62.5 mg - so I'll wait to see how much success I have with 250 mgs.
Thanks again - Jane
> Hi Jane,
>
> I forgot to answer your weight loss question.
>
> It doesn't seem to make me feel "full" or
> "nauseaus" like stimulants or Wellbutrin.
>
> I just don't ever feel hungry. So I don't think
> it is speeding up my metabalism. Why I don't
> ever feel hungy is a mystery that the doctor's
> can't explain. I still can enjoy food. And if
> I eat too much, then my stomach does send me
> a "full" signal.
>
> What were you referring too WRT to zoloft?
>
> -John
>
>
>
> >
> > Jane,
> >
> > The only reason I can think that topomax is
> > curing my myofacial pain is that one of its mode
> > of anti-convulsant action is similiar to klonopin's
> > mode on anti-convulsant action. I read this in an
> > article which compared topamax to diazepam.
> > Basically there are 2 types of Gaba neurons, GabaA
> > and GabaB, an elelectrolyle chlorine is negatively
> > charged and is passed through the neuron to inhibit
> > the conductance of the receiver of the neuron.
> > Both Klonopin and Topomax increase CL- (chlorine)
> > conductance in the GabaA type neuron. Other meds
> > like Depakote works on the GabaB type neuron.
> > Other anti-convulsants try to prevent the break
> > down of gaba instead of trying to enhance the working
> > of gaba. I'd explain neurologically why I think
> > stimulating GabaA neurons is good (as well as blocking
> > serotonin 5ht-2a neurons or noradrenaline alpha-1
> > neurons) but it is rather involved. The net
> > result in my case is increased dopamine in
> > an are of my brain where dopamine inhibits
> > acetycholine stimulation of muscle contraction
> > of jaw/head muscle contraction.
> >
> > At least that's MY theory,
> > and my response to a wide variety
> > of meds is consistent to it.
> >
> > meds that relieve my pain:
> >
> > anticholinergics: benadryl,chlorphenramine
> > dopaminergic:Adderall,
> > 5ht-2 antagonist:Zyprexa,Serzone
> > GabaA:Klonopin,Topomax.
> >
> > Why I don't get the other side effect typical to
> > anti-convulsants is a bit of a mystery. Usually
> > the anti-convulsants make me stuporous,slurred speech, and give me
> > blurry vision, Topomax just givems me the same
> > side effects as Klonopin, which is a slight sedation.
> > Topamax also modulates gluatamate at the AMPA
> > receptors and Lamictal modulates gluatmate at
> > the NMDA receptors. ITS POSSIBLE (just a hypothesis),
> > that some sort of interaction with lamictal actually
> > stabilizes the Topmax (kinda like a mood stabilizer,
> > right...twilight zone...).
> >
> > Anyways, at the GabaA receptor I would only expect
> > sides effects like the benzos, but at the AMPA I
> > might expect side effects like the other
> > anti-convulsants. Just my 10 cents.
> >
> > -john
> >
> >
> >
> >
> >
> > > Hi John -
> > >
> > > Topamax is pretty interesting to me, especially in conjunction with Lamictal and Zoloft. How does it manage to be both sedating and weight-loss promoting? I thought only activating drugs sped up the metabolism enough to cause weight loss. Also, are you experiencing any cognitive dulling? A lot of people seem to complain about it, and god knows my brain is already dulled enough. Good news about the facial pain - any theories why it's working?
> > >
> > > - Jane
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
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