Posted by Sunnely on November 11, 2000, at 23:28:25
In reply to Topamax, Sedation, and Other Side Effects, posted by Kingfish on November 9, 2000, at 16:04:30
Hi Kelly,
The most frequently reported side effects of topiramate (Topamax) are sleepiness, dizziness, unsteadiness, speech disturbances, cognitive dysfunction, psychomotor slowing, headache, nausea, nystagmus (rapid eye movement horizontally or vertically), tremor, fatigue, gastrointestinal upset, visual disturbances, and kidney stones. Dose-related side effects (i.e., the higher the dose, the higher the chance) include mood lability, weight loss, loss of appetite, tremor, fatigue, nervousness, difficulty concentrating, confusion, depression, and anxiety.
Among the anticonvulsants currently available in the US, Topamax appears to be the least associated with weight gain, and, in fact, may be associated with weight loss in many patients. Weight gain is a significant problem with many psychotropic medications, including antidepressants, mood stabilizers, and antipsychotics - especially the atypical antipsychotics clozapine (Clozaril) and olanzapine (Zyprexa). Due to its positive mood and appetite suppressant effects, Topamax has been used as adjunctive (add-on) treatment to treat bipolar disorder and to offset the weight gain associated with psychotropic drugs commonly used to treat bipolar disorder and schizophrenia.
Re: Kidney stone formation:
Approximately 80% of Topamax is eliminated by the kidneys. In epilepsy trials, 1.5% to 2.0% of Topamax-treated patients developed kidney stones. One of the actions of Topamax is inhibition of carbonic anhydrase (an enzyme). As a class, carbonic anhydrase inhibitors like Topamax, acetazolamide (Diamox), and zonisamide are known to be associated with kidney stones. While the rate of occurrence of kidney stones with Topamax, 1.5% to 2% is low, the risk appears to be greater with increased dosage and in males between the ages of 21-54 years. To date, there is no apparent relationship between stone formation and duration of Topamax treatment. For patients taking Topamax to lose weight, the risk of kidney stones may be increased even further if they are also on a high-protein, "Atkins"-like diet, which promotes ketosis and therefore stone formation. To minimize this risk, patients on Topamax should avoid these types of diets and to increase their fluid intake.
poster:Sunnely
thread:48562
URL: http://www.dr-bob.org/babble/20001102/msgs/48697.html