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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Angel Girl on May 18, 2003, at 23:05:14
I'm BP-II and currently taking 1,500mg/day of Depakote. It is a Godsend as far as regulating my mood swings but unfortunately it came with some unwanted side effects. I started experiencing changes in my hair texture, to which I HATE and also my hair was falling out. My pdoc advised taking Zinc and Selenium for that and it works wonderfully. BUT the other side effect that I'm still wrestling with is considerable weight gain. I've been seriously thinking of switching to Topomax in hopes that it will help me get off some of the weight I've put on with the Depakote.
Does anybody know if there has been any studies done on how well Topomax works for BP compared to Depakote. And also, any opinions on changing from the Depakote to Topomax would be greatly appreciated. I'm seeing my pdoc this Wednesday and I'd like to be as knowledgable as I can.
Thanks in advance.
Angel Girl
Posted by Ritch on May 19, 2003, at 9:45:25
In reply to Depakote / Topomax, posted by Angel Girl on May 18, 2003, at 23:05:14
> I'm BP-II and currently taking 1,500mg/day of Depakote. It is a Godsend as far as regulating my mood swings but unfortunately it came with some unwanted side effects. I started experiencing changes in my hair texture, to which I HATE and also my hair was falling out. My pdoc advised taking Zinc and Selenium for that and it works wonderfully. BUT the other side effect that I'm still wrestling with is considerable weight gain. I've been seriously thinking of switching to Topomax in hopes that it will help me get off some of the weight I've put on with the Depakote.
>
> Does anybody know if there has been any studies done on how well Topomax works for BP compared to Depakote. And also, any opinions on changing from the Depakote to Topomax would be greatly appreciated. I'm seeing my pdoc this Wednesday and I'd like to be as knowledgable as I can.
>
> Thanks in advance.
>
> Angel Girl
I *believe* that Topamax is in Phase III trials for acute mania (that's from memory though!), which would give it the same FDA indication as Depakote. There have been some isolated posts about it triggering hypomania here, though, so it may not be as potent an antimanic as Depakote or Lithium. Also, TOP has a nasty tendency to cause cognitive blunting and memory problems-sometimes these don't fade for some people. For this reason it needs to be titrated up slowly. Given that, you might be better off *cross-tapering* the Depakote with the Topamax, i.e., dropping the Depakote to 1000mg and adding Topamax, and seeing how you tolerate it and how well it works for you. You might find that both meds work quite well, but at lower doses. Weight gain on Depakote is dose-dependent.
Posted by Angel Girl on May 19, 2003, at 15:46:53
In reply to Re: Depakote / Topomax » Angel Girl, posted by Ritch on May 19, 2003, at 9:45:25
>
> I *believe* that Topamax is in Phase III trials for acute mania (that's from memory though!), which would give it the same FDA indication as Depakote. There have been some isolated posts about it triggering hypomania here, though, so it may not be as potent an antimanic as Depakote or Lithium. Also, TOP has a nasty tendency to cause cognitive blunting and memory problems-sometimes these don't fade for some people. For this reason it needs to be titrated up slowly. Given that, you might be better off *cross-tapering* the Depakote with the Topamax, i.e., dropping the Depakote to 1000mg and adding Topamax, and seeing how you tolerate it and how well it works for you. You might find that both meds work quite well, but at lower doses. Weight gain on Depakote is dose-dependent.Ritch
Thanks for your input. I should've been more explicit. Tapering the 2 drugs is the method that has been discussed between my pdoc and myself. I've read through the archives and read that if the TOP is introduced and increased SLOWLY that cognitive dulling may be avoided. I hadn't found any posts that referred to TOP triggering hypomania.
Thanks again for your input.
Angel Girl
Posted by Ron Hill on May 20, 2003, at 3:49:23
In reply to Depakote / Topomax, posted by Angel Girl on May 18, 2003, at 23:05:14
Angel Girl,
Just a brief aside. You sound a whole lot better these days than you did a year or so ago when you seemed to be tossed from one crisis state to another. I'm glad you are doing well and I hope you find a solution to the Depakote weight problem.
-- Ron
This is the end of the thread.
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