Posted by Larry Hoover on November 2, 2004, at 8:22:21
In reply to Re: for Larry Hoover » iris2, posted by rainy on November 1, 2004, at 9:02:44
> "Book answers?" by this I guess you mean not lab answers?
I mean I don't have clinical experience with drugs, and patients. I can look things up, and understand most of what I find, and I can translate geek to layman.
> A neurologist told me that Topmax effects the entire nervous system and is responsible for my declining handwriting, tendency to lose my balance, and other annoying neurological signs and symptoms. He also said they would disappear when the Topamax clears out of the body. Um, Lar, is this true and further, how does this medicine work?
I can tell you that a fairly common nickname for Topomax is Stupimax. It is, literally, a confusing drug, for many people.
How does it work? First, we are unlikely to know everything it does. To know that, we'd have to know how everything works, and we don't. But here is the blurb from the monograph: "Electrophysiological and biochemical evidence suggests that topiramate, at pharmacologically relevant concentrations, blocks voltage-dependent sodium channels, augments the activity of the neurotransmitter gamma-aminobutyrate at some subtypes of the GABA-A receptor, antagonizes the kainate subtype of the glutamate receptor, and inhibits the carbonic anhydrase enzyme, particularly isozymes II and IV."
The first would slow down overall brain activity. The second would have a calming effect, moodwise. The third would suppress one special type of excitatory signal. The last would suppress respiration (I think).
> I don't understand the package insert, either. The mechinism of action part.
> rainyWell, I'm not sure what that says, exactly.
Topamax is a very unique drug, structurally. It's a modified form of the fruit sugar, fructose. It readily crosses the blood-brain barrier because it probably still "looks like" a sugar to the transporters.
Lar
poster:Larry Hoover
thread:5053
URL: http://www.dr-bob.org/babble/20041029/msgs/410512.html