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Re: Our Love/Hate Relationship with Nardil » SLS

Posted by Ron Hill on December 31, 2009, at 6:05:28

In reply to Re: Our Love/Hate Relationship with Nardil » Ron Hill, posted by SLS on December 30, 2009, at 6:31:35

> Hi Ron.

> > I think I'm going to add topiramate (Topamax) due to it's weight loss effect. Further, some studies indicate that topiramate can treat bipolar depression and rapid cycling.

> I actually like Topamax. I have been on it twice, and although it has not made much of an impact on depression, I found it to be a very clean drug with few side effects. Several doctors I have spoken to have observed that cognitive side effects can be minimized by titrating very slowly. I started at 25mg per day and increased by 25mg every week. One could go even slower than that, of course. It seems that if you don't trigger the cognitive side effects in the first place, they can be avoided. 100mg seems to be a good target dose for bipolar disorder. You might need to go to 200mg, but I don't think there is much more benefit to be gleaned at dosages higher than that.

Most studies I've read, and ancedotal reports on this site, indicate that weight loss does not kick-in fully until 175 or 200 mg/day. I hope it does not make me depressed and, thereby, require me to quit the trial.

> I did notice that my muscles fatigued more quickly.

I don't like that.

> It might be a result of the carbonic anhydrase inhibition. I am not sure. Be sure to drink lots of water to help avoid the production of kidney stones.

> Good luck with Topamax. I think it is a good choice. If I do not respond adequately to the addition of Effexor, I might revisit it.

Thanks for the information, Scott. I'd like to save my health insurance company some money by biting 100 mg tablets into four pieces to get my start-up 25 mg doses. There isn't any reason why I should not break the 100 mg tablets, is there?

-- Ron


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poster:Ron Hill thread:931242
URL: http://www.dr-bob.org/babble/20091227/msgs/931749.html