Posted by Mitch on August 6, 2001, at 8:15:11
In reply to Re: Topamax or Trileptal?, Mitch, anyone?, posted by amuse on August 5, 2001, at 20:58:32
> Dear Mitch, I am interested in Topomax a drug I dont know much about. The reaction of these two clients of mine, very sick and probably bi-polar and PTSD, was so dramatic, still it could have been a coincidence, I asked my pdoc about it and he was incredibly discouraging reeling off all the nasty side effects. I also have been on low-dose polypharm for almost eight years. Paxil 5mg, imiprimine 50, wellbutrin 300, and lithium 600 keeps me feeling good and normal most of the time. Never had complete remission of depression until I started on lithium about four years ago. I am always looking for meds with out the nasty side effects the two that bother me the most, sexual dysfunction and weight gain. Dont think I will get a chance to try topomax. The doses the nurses used were also I understand sub theraputic, for nightmares from PTSD. I would go on an MAO inhibitor except pdoc says they have the same side effects. I think I probably have a bi-polar two diagnosis but was mostly depressed. Now I feel great most of the time.
I suspect the reason your pdoc is hesitant to try it is because of the number of meds that you are already taking. He might be afraid of neurotoxicity by adding it (especially with the lithium). He also may not be inclined to use meds "off label". Topamax isn't approved by the FDA for bipolar, yet. Obviously the lithium has helped you a great deal-you said "complete remission". He probably thinks that you are fairly stable and doesn't want to make a lot of waves by adding any new meds, that's all (I counted 3 AD's). If you still feel insistant about trying topamax approach him with the idea of a substitution with one of your other meds-say Paxil for instance. If you do start topamax (esp. given your other meds in the mix), you need to start off as low as you can and be patient increasing-it can really fog up your head if you jack the dose up too quickly or start off with too much of it.
Mitch
poster:Mitch
thread:71234
URL: http://www.dr-bob.org/babble/20010804/msgs/73746.html