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Re: Tegretol/Topamax Combo Anyone been on this? » Nickengland

Posted by SLS on June 3, 2005, at 11:08:20

In reply to Re: Tegretol/Topamax Combo Anyone been on this?, posted by Nickengland on June 3, 2005, at 10:18:26

Hi Nick.

> Well as you know the Trielptal was great for my mood but had to be stopped because of kidney pains.

I know. How weird is that?

> Now i'm back on Tegretol and its no way near as effective..I feel more depressed - my mood seems more heavy for want of a better word if you get what I mean.

In what ways did Trileptal improve your depression?

I sure do. Good word for it. Do you experience a feeling of general malaise with it? That's what I felt when I first started taking Trileptal. It still persists actually, but had not been as bad the longer I stayed on it. I discontinued it yesterday as it wasn't doing enough for me, and I wanted to see what would happen. Sometimes you don't realize how much a drug has been helping you until you stop taking it. My doctor asked that I keep the dosage down to 300mg. He also said that I could discontinue it to see what would happen. Well, I experienced a rebound worsening of depression that lasted for half a day and then subsided. I feel ok today. I might go back to it at 600mg just to compare, but I need to decide on a stable regimen within the next 4 weeks. If all goes well, I'll be trying mifepristone using the 7-day protocol in a month or two.

> I'm also experiencing more head aches, something I didn't get from Trielptal and I have an increase in sweating which is uncomfortable. All in all though the Tegretol is still better for me than either lithium, sodium valproate or lamotrigine.

You might want to look into Keppra. No reason in particular. It's just one more anticonvulsant available for consideration. A doctor Kenneth Kaufman published a case study of a woman whom was a rapid cycler and refractory to many polypharmaceutical treatments. She is now doing very well using Keppra as monotherapy. She tried to come off of it once, but relapsed.

> With Topamax if i'm successful getting it prescribed (my current psychiatrist didn't even know of Trileptal until i suggessed it) I hope to gain from it this:
>
> It has a side-effect of decreasing sweating, which is very much a plus for me as I overly sweat anyway even without meds.
>
> Its supposed to be good for preventing migraine head aches..again something good for me.
>
> As I understand, Tegretol, Trileptal and Topamax are the 3 main meds that mainly work on the Temporal Lobes. I've responded best to these medications out of all the other mood stabilisers, so my logic seems to think that *perhaps* Topamax would help too, although its just guess work, I strongly believe Topamax would be worth considering taking into account as it works on the Temporal Lobes and teg and tri have helped so much.
>
> It will either be a case of adding, or trying Topamax alone, I'd prefer it alone if possible. If push comes to shove maybe the 2 would work better..all guess work until I try lol maybe the Topamax will makes things worse?!
>
> Are you thinking of trying Topamax...?

If I see enough people find it an effective antidepressant, I will probably move it higher on my list of things to try.

I'm sure you know this, but the more gradually you titrate Tompamax, the more likely you are to avoid completely the cognitive side effects. Once triggered, these negative effects tend to linger. I was just thinking about this yesterday. If two people begin taking Topamax on the same day; person #1 using a rapid titration and person #2 using a gradual titration; at the end of six months, person #1 will still be experiencing cognitive impairments while person #2 will not. It is worth the investment in time to go slowly. Unfortunately, I am not yet familiar enough with dosing of Topamax to suggest a titration schedule.

Get well.


- Scott

 

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