Posted by Cam W. on June 10, 2000, at 4:56:16
In reply to Re: Topamax, posted by kady on June 9, 2000, at 15:25:01
Kady - I guess Topamax could be used for migraines depending upon the focal point of the migraine (eg headaches originating from the temporal lobe, perhaps), but I have not seen it used in migraines (this does not mean that it hasn't been, though).The cognitive dulling (eg name finding, simple math problems) is usually a side effect of raising the dose too fast. A slow titration is needed. Like Andre said, it is usually started at 25mg per day (it can be in a divided dose, but once daily dosing is usually okay). You can then increase the dose by 25mg or 50mg per week (depending upon tolerance and side effects) to a target dose of 200mg to 600mg daily. I have read about it being used in bipolar disorder at doses up to 1400mg per day, but generally, most researchers agree that doses greater than 600mg per day in bipolar disorder are not anymore effective than larger daily dosages. I see an average dose of 200mg to 400mg daily used (but in a few of those 200mg per day cases I would like to see the dose raised just a little more - it just needs to be done slowly).
As for weight loss with the drug, I do see it in about 20% or 30% of patients, but definitely not everyone. I would not use it for weight loss alone because it is a powerful mood stabilizing and antidepressant drug. It does seem to work well in many cases of bipolar depression usually as an add-on (adjunctive) agent or sometimes as a monotherapy. I have only seen it used as a monotherapy a couple of times. It is usually added to a traditional mood stabilizer or Zyprexa (to try to decrease or slow the weight gain, hoping for an added bonus of improved mood).
- Cam
poster:Cam W.
thread:36352
URL: http://www.dr-bob.org/babble/20000610/msgs/36810.html