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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 3 of 3. This is the beginning of the thread.
Posted by Kelty on April 1, 2002, at 22:50:30
I am looking for a new medication to try after having taken nortriptyline for the last five years. I had tried many different types of antidepressants in the 7 years before that and was considered treatment resistant. I have been managing on nortrip but still have problems with anxiety and cycling depression. The biggest problem is a weight gain of over 100 lbs which at my age (40, female) is a serious threat to my health. I have experienced terrible carbohydrate cravings while on any tricyclic that I have tried.
Other issues I have to consider when deciding on a med are that I have fibromyalgia and that nortriptyline has been able to keep migraines at bay for the most part. As a result of some reading I have done recently, I have begun to wonder if I am actually bipolar II, due to the cycling nature of my depression and the strong anxiety factor. (I have not seen a pdoc in about 3 years. GP is doing my prescribing.)
Any suggestions would be helpful.
Posted by TSA West on April 2, 2002, at 0:14:42
In reply to Kramer: need to try a new med, posted by Kelty on April 1, 2002, at 22:50:30
Hopefully you will find my brand new promo for Topamax (Topiramate) informative and handy. I took Topamax for three months in 2001.
Topamax is a great addition to the mood stabilizer armamentarium, and I will list the reasons why I believe Topamax is effective with many facets:
--Weight loss observed with Topiramate.
(Topiramate: a review of its pharmacodynamic and pharmacokinetic properties and clinical efficacy in the management of epilepsy. Drugs 1997)--Cognitive side-effects are minimal with Topiramate after 6 months of continuous use.
(Meador KJ. Cognitive effects of epilepsy and of antiepileptic medications. In: WyllieE, ed. The treatment of epilepsy: principles and practice. 1999).--Topamax is efficacious in migraine headaches. "Prophylactic treatment with topiramate is more effective than placebo at reducing the rate of migraines in patients who experience >= 2 migraines per month, report researchers from the US." (Inpharma Weekly, February 2002. Topiramate promising in migraine prophylaxis).
--Topamax finds utility in binge-eating disorders:
"We report on a morbidly obese woman with binge-eating disorder with no neuropsychiatric comorbidity who failed to respond to other agents and was successfully treated with topiramate." (Topiramate for Binge-Eating Disorder." American Journal of Psychiatry June, 1998. APPOLINARIO, JOSÉ C. M.D.)--Topamax is good for all parts of bipolarity
--Topiramate has no anticholinergic effects.
--It comes in sprinkle capsules for children.
--It has no effect on cardiovascular systems.
--It has no effect on hepatic enzymes.
--It is combinable with most every antidepressant/anticonvulsant.
--Its efficacy in epilepsy guarantees psychiatric patients taking Topamax will not have a seizure on Tricyclic antidepressants.I wish you the peace of God in your endeavors....
-------------------------TSA West--------------
Posted by Dr. Kramer on April 2, 2002, at 11:31:55
In reply to Kramer: need to try a new med, posted by Kelty on April 1, 2002, at 22:50:30
> I am looking for a new medication to try after having taken nortriptyline for the last five years. I had tried many different types of antidepressants in the 7 years before that and was considered treatment resistant. I have been managing on nortrip but still have problems with anxiety and cycling depression. The biggest problem is a weight gain of over 100 lbs which at my age (40, female) is a serious threat to my health. I have experienced terrible carbohydrate cravings while on any tricyclic that I have tried.
>
> Other issues I have to consider when deciding on a med are that I have fibromyalgia and that nortriptyline has been able to keep migraines at bay for the most part. As a result of some reading I have done recently, I have begun to wonder if I am actually bipolar II, due to the cycling nature of my depression and the strong anxiety factor. (I have not seen a pdoc in about 3 years. GP is doing my prescribing.)
>
> Any suggestions would be helpful.My first suggestion is to get your own psychophramacologist! Sounds like your situation is beyond the expertise of a primary care doc. There are lots of meds that are considerably less likely to cause weight gain than the TCA you're on.
This is the end of the thread.
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