Posted by Nickengland on August 6, 2005, at 18:04:30
In reply to Re: Keppra (levetiracetam) for bipolar disorder? » Nickengland, posted by SLS on August 6, 2005, at 15:05:38
Hi Scott,
>I can't believe you went back and checked that out! Yes, I have avoided Topamax because of its cognitive side effects. How silly, right? Considering the severity and refractoriness of my condition, it doesn't make sense to avoid it forever. I guess I should go ahead and put it back near the top of my list of things to try. Thanks. One more ray of hope to cling to.
I have another surprise for you..lol I didn't need to go and check the list as I remembered specifically that Topamax wasn't on it! :-) I have a very good longterm memory for things that interest me - quite literally they stay in mind. that said my everyday short-term memory is a joke, I forget everything, but longterm I have the memory of an elephant lol On a serious note, it maybe of interest (I read somewhere a couple of years ago, memory again, see lol) that one of the benefits, yep benefits of manic-depressives, is that they quite often have very good longterm memories..Good and bad I guess, but mine are often based on factual information.
Anyway, i'm waffling again lol
To be perfectly honest with you, I really havent found the cogitive effects that bad at all. In fact carbamazepine, lithium and sodium valproate I found had worse cognitive side effect compared with Topamax so far. That said, like yourself, before trying Topamax, the 'Dopamax' fear was the thing that held me back.
I always looked at it like this aswell, interms of firstline and order of what should be tired first for a mood stabilser (this is in order of what I tired first to get to Topamax)
Sodium Valproate
Lamotrigine
Lithium
Lamotrigine (shortly again)Carbamazepine
Oxcarbazepine
Gabapentin
Topiramate
Finally ending with Topiramate and Gabapentin so far (plus omega 3 fish oils & Taurine - taurine is one great supplement, proven anticonvulsant properties and great calming effect)
*Experimental - Niacinamide & Tyrosine (vitamin C and vitamin b complex thrown in just for good measure!
I'm possibly wondering about a gabba supplement, but somehow don't see the point, although that Amen psychiatirst thinks its good..Hmmm Blood brain barrier has got me on that one, seeing as it doesn't cross it.>Did the antidepressant effect fade with time?
Like most medication that had a great intial response (for me Trileptal & Gabapentin) the first few days, first week was the best. My body then adapted and of course this did fade alittle. That said, the effects (positive) have still remained and I would say have leveled off to some extent. Nothing perfect, but i'm coping you know, take away the medication and i'd have to deal with the illness and that far, far worse. So all in all I'd say the benefits are still there. The anti-depressant response from this for me, has been alot more pronouced than that of Trileptal, that for sure. It works so differently from Trileptal, I mean side effects wise, not so much drowsyness and no blurred vision. Its different, a whole new ball game. I will say there are side effects and in some repects its not as 'smooth' as Trileptal. I really like the stuff though. Given the choice now if I didnt have the kidney thing with Trileptal, you know id probably stay with Topamax. Oh its great for headaches as well as an added bonus - if you get these, I do and now with this I do not anymore, well very rarely.
> Of interest as well, I've read that Tegretol, Trileptal and Topamax are the main 3 medications that effect the Temperal Lobes.
>Hmm.
I know, lol i'm no expert on the Temeral Lobe area of the brain and i'll adit I got this information from 'crazymeds.org' Thats said, there are pubmed studies that confirm topamax was shown to work on areas of the temeral lobes. (I think) that study may have been on rats lol hmmm No seriously, I've heard its good for temperal lobe epilepsy, there must be a link somewhere. Tegretol is a first line medication for temeral lobe epilepsy, trileptal related. Topamax would be second line for Temperal lobe epilepsy I think. Dr Amen speaks about bipolar being a Temperal lobe condition on his site from what I can gather with responds to anticonvulsants. There could be a link somewhere?
>Damned tachyphylaxis!
Im not sure what tachyphylaxis is?..does not sound good though! :-(
>How long and at what dosage do you feel I should wait before passing judgment?
Thats a very difficult question for me to answer Scott. Its my understanding that huge un-wanted side effects would be the limiting factor in you continuing with Topamax. That and the fact, that because of these side effects you would be getting no real benefit. If that was the case then dosage would only be small, perhaps only in the region of 25-75mg, thats if what I am saying would be true for you and it then could only be a matter for a few weeks, 1 month tops. This could be an unfair judement though based on my experience of medications and more so topamax...I wouldn't want to add anymore as I know there are many more factors with yourself. Bearing in mind your on other medications and you will no doubtly react differently somewhat to me. In general though, I think and feel with this medication, you'll either love it or hate it. I know its hard, but try not to think about quiting it, before you try it :-)
Go low and slow is definately the key if you decide. When I first started it was at 25mg for afew weeks and I had some word finding problems but funnily enough could laugh them off (see what I mean either love it or hate it) anyway, due to some circumstances I re-started the medication and this time at 12.5mg. It certianly made a difference with those word finding skills, when I reached 25mg and now i'm at 37.5mg I dont even have that originally problem that I had back then when I jumped straight in at 25mg, if you get what I mean.
I hope that helps
:-)
Kind regards
Nick
poster:Nickengland
thread:538236
URL: http://www.dr-bob.org/babble/20050803/msgs/538411.html