![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 45 to 69 of 1085. Go back in thread:
Posted by phillybob on January 25, 2001, at 23:21:16
In reply to Re: Topamax Experiences? » KarenK, posted by Lexie on January 25, 2001, at 19:43:28
Anger/Highs: I'd say I feel a bit more "engaging" with topiramate than without it (though I can not compare it to it having been on either Depakote or Lithium because I had not been on either one of those for any significant period of time). I do seem to get angry and do seem to get high but not in an unhealthy way. I most certainly do not seem numb or desensitized to such sensations. They are in no way out of control.
Sedation (to Kingfish, in particular): I knew exactly what you were talking about. If you you re-read my earlier posts, you shall see. I was fortunate to have the liesure to increase the dosage at a fairly quick pace with not much daily obligation pressures so sleeping/napping was not a huge problem for me. However, once the dosage surpassed the 150 mg (I think)/day mark, the daytime sedation seem to begin to dissipate. Perhaps, if you can find some way to find the freedom of time to experiment in increasing the dosage and sustaining/maintaining it at such higher levels, you might find the same ... ?
Sores: I do now recall mouth sores, now that you mention it, but no longer evident.
P.S. Still tootin' along just fine. Went bowling tonight with pals (of course, none of us are bowlers :)
Posted by Kingfish on January 30, 2001, at 5:30:31
In reply to Re: Topamax - Anger/Highs, Sedation, Sores, posted by phillybob on January 25, 2001, at 23:21:16
phillybob:
thank you for the suggestion re: dosage and sedation. I am at a larger dose now (150) and the sedation does seem to be better. I appreciate the advice!
Posted by maribeth on January 30, 2001, at 7:56:05
In reply to Re: Topamax - Anger/Highs, Sedation, Sores » phillybob, posted by Kingfish on January 30, 2001, at 5:30:31
> phillybob:
>
> thank you for the suggestion re: dosage and sedation. I am at a larger dose now (150) and the sedation does seem to be better. I appreciate the advice!Hi y'all
I pretty much agree with all of you. I seem to have the most calming "smoothed out" effect around 200mgm However,
my pdoc wants to take me up to 300 or 400mgm as at 200 the effect is not well sustained and the weightloss/appetite
supression is not working. Right now I have the luxury of being able to be at home or where i can "titrate" the dose.
(monitor dose/effect) and my pdoc is very good about this. Hang in there you all. Sorry I can't relate to the Depakote
etc, but this is the first "mood stabalizer" I have ever been on. (I did the mouth sore bit though; Xylocaine 2% from
the family doc worked well-also stay away from toothpastes with sodium (something)laureate.
Blessings Maribeth
Posted by sherry gomez on January 30, 2001, at 14:59:42
In reply to Re: Topamax - Anger/Highs, Sedation, Sores, posted by maribeth on January 30, 2001, at 7:56:05
> > phillybob:
> >
> > thank you for the suggestion re: dosage and sedation. I am at a larger dose now (150) and the sedation does seem to be better. I appreciate the advice!
>
> Hi y'all
> I pretty much agree with all of you. I seem to have the most calming "smoothed out" effect around 200mgm However,
> my pdoc wants to take me up to 300 or 400mgm as at 200 the effect is not well sustained and the weightloss/appetite
> supression is not working. Right now I have the luxury of being able to be at home or where i can "titrate" the dose.
> (monitor dose/effect) and my pdoc is very good about this. Hang in there you all. Sorry I can't relate to the Depakote
> etc, but this is the first "mood stabalizer" I have ever been on. (I did the mouth sore bit though; Xylocaine 2% from
> the family doc worked well-also stay away from toothpastes with sodium (something)laureate.
> Blessings Maribeth
hi, I am
seeing the doctor this friday, am on 300mg of topamax, I really want to say on it, but I dont think my husband wants me to stay on it as by moods are still roller coastering, if fact he is taking the day off on friday to take to to the doctor. I wish I could get rid of these sores on my tongue..I am so afraid they are going to put me back on depakote. Anyway I lost nearly 40 pounds!! I am down to 103pnds.
Posted by Janice1 on January 30, 2001, at 17:48:04
In reply to Re: Topamax - Anger/Highs, Sedation, Sores » maribeth, posted by sherry gomez on January 30, 2001, at 14:59:42
11 cavities in one year!!!! I thought it was 6 cavities in a previous thread, but I have 11 cavities. From the dry mouth created by the Topamax. I called topiramates head office who informed me this is an uncommon but known possible side effect of the medication.
Also I am stupider (see!!! not even a word).
But I am pretty happy and stable.
Janice
100 mg Topamax
750 mg Lithium
150 mg Wellbutrin
Posted by phillybob on January 30, 2001, at 20:43:18
In reply to Re: Topamax - How's this for a side Effect..., posted by Janice1 on January 30, 2001, at 17:48:04
Dry Mouth: drink lots of water, perhaps? this will also help prevent the dreaded kidney stones.
Dumbeding (heh, heh) and Mouth Sores: I think both of these are actually helped significantly by the addition of a B Complex vitamin supplement (at least, I have found this to be so)
Rollercoastering (for sherry gomez): I don't really know much about your situation or what your complete medication "picture" is (nor am I even a doctor for that matter), but it seems like you are having some benefits from the topamax. Perhaps, you might be able to remain on the topamax as an "adjunct" to a traditional mood stabilizer like depakote or lithium. Thus, you'd be on two mood stabilizers. (Though, I am preferring to refer to topiramate/topamax as a "neuromodulatory" drug these days).
Posted by KarenK on January 31, 2001, at 11:09:26
In reply to Re: Topamax - How's this for a side Effect..., posted by Janice1 on January 30, 2001, at 17:48:04
> 11 cavities in one year!!!! I thought it was 6 cavities in a previous thread, but I have 11 cavities. From the dry mouth created by the Topamax. I called topiramates head office who informed me this is an uncommon but known possible side effect of the medication.
>
> Also I am stupider (see!!! not even a word).
>
> But I am pretty happy and stable.
>
> Janice
> 100 mg Topamax
> 750 mg Lithium
> 150 mg WellbutrinJanice,
I just went to the dentist last nite and I asked him about the topamax dry mouth. He told me to get three things: 1) Biotene gel or chiclets, 2)enamelon toothpaste, and 3) gel cam fluoride gel. The first one is to increase saliva. The last 2 are to keep you from getting cavities. He said a lot of meds do this to you even cardiac meds. Anyway I lucked out with no cavities and the dental tech told me that medically speaking she didn't think I had dry mouth. WebRX carries Biotene products. I haven't gone to the drug store yet so I haven't tried any of these yet. I agree it is irritating so I thought I would pass the info on.
KarenK
Posted by phillybob on February 3, 2001, at 7:37:13
In reply to Re: Topamax - How's this for a side Effect..., posted by KarenK on January 31, 2001, at 11:09:26
Six weeks does not a full and complete recovery make, but I am doing very nicely with the 125 mg in the am and 100 mg in the pm plus a super B-complex stress vitamin tab in the evening as my monotherapy.
Just thought I'd post as encouragement for others and ... therapy for me ... thanks for listening.
As I hopefully will continue to do the same (well), I'll post less frequently on my success (but still update at intervals) and respond to questions within this thread (I'm notified) or to direct emails. Thanks for hearing me out. :)
Posted by phillybob on February 20, 2001, at 22:05:34
In reply to Topamax Experiences? (a.k.a. the longest thread), posted by phillybob on February 3, 2001, at 7:37:13
Okay, was coastin' along just fine but got my Rx filled and thought I was takin' 237.5 mg (137.5 plus 100) but was really takin' 275 mg total (!, exclamation, because I'm hypersensitive to meds) cause I never looked at the small pill bottle and ended up havin' some untoward effects. Since then I've tapered back down to 200 mg/day total.
But, I've got that sore throat again, which I believe is actually bein' caused by bleeding from my gums irritating my throat ... a known, though infrequent, side effect per my doctor. Now, I am also paranoid about Janice's comment about cavities because of this whole "mouth ordeal." Hmmmm. Things had been goin' fairly well (and still really are but for my mouth).
I am gonna' be addin' 10mg of Prozac (an AD which I was actually on and was still in my system when I first started Topamax) though because ... uh ... er ... let's just say ... the topiramate is helping me (a male) complete the sexual act just a tad too fast and the Prozac's been a good one to counteract that for me.
Posted by Bob on February 20, 2001, at 22:53:00
In reply to Re: Topamax Experiences? , posted by phillybob on February 20, 2001, at 22:05:34
> Okay, was coastin' along just fine but got my Rx filled and thought I was takin' 237.5 mg (137.5 plus 100) but was really takin' 275 mg total (!, exclamation, because I'm hypersensitive to meds) cause I never looked at the small pill bottle and ended up havin' some untoward effects. Since then I've tapered back down to 200 mg/day total.
>
> But, I've got that sore throat again, which I believe is actually bein' caused by bleeding from my gums irritating my throat ... a known, though infrequent, side effect per my doctor. Now, I am also paranoid about Janice's comment about cavities because of this whole "mouth ordeal." Hmmmm. Things had been goin' fairly well (and still really are but for my mouth).
>
> I am gonna' be addin' 10mg of Prozac (an AD which I was actually on and was still in my system when I first started Topamax) though because ... uh ... er ... let's just say ... the topiramate is helping me (a male) complete the sexual act just a tad too fast and the Prozac's been a good one to counteract that for me.I've had frequent sore throats on topo also.
Bob
Posted by maribeth on February 21, 2001, at 7:04:36
In reply to Re: Topamax Experiences? , posted by phillybob on February 20, 2001, at 22:05:34
> Okay, was coastin' along just fine but got my Rx filled and thought I was takin' 237.5 mg (137.5 plus 100) but was really takin' 275 mg total (!, exclamation, because I'm hypersensitive to meds) cause I never looked at the small pill bottle and ended up havin' some untoward effects. Since then I've tapered back down to 200 mg/day total.
>
> But, I've got that sore throat again, which I believe is actually bein' caused by bleeding from my gums irritating my throat ... a known, though infrequent, side effect per my doctor. Now, I am also paranoid about Janice's comment about cavities because of this whole "mouth ordeal." Hmmmm. Things had been goin' fairly well (and still really are but for my mouth).
>
> I am gonna' be addin' 10mg of Prozac (an AD which I was actually on and was still in my system when I first started Topamax) though because ... uh ... er ... let's just say ... the topiramate is helping me (a male) complete the sexual act just a tad too fast and the Prozac's been a good one to counteract that for me.I am back in the thread again having been travling for several weeks. I am currently on 450mgm/day of Topamax and my
pdoc has me working up in increments of 50mgm/week to 600mgm. so far so good. The only side effects were the mouth sores
at 200mgm that lasted one week and some cognitive scrambling around that time also.
I occasionally experience some MINOR word retrieval problems but, Phillybob, I'm back to my old form in Jeopardy! Maribeth
Posted by phillybob on March 4, 2001, at 23:27:39
In reply to Re: Topamax Experiences? , posted by maribeth on February 21, 2001, at 7:04:36
I feel like I was playin' a pinball game and now the "Game Over" is flashing.
I had to discontinue the topiramate due to aforementioned bleeding gums which, it turns out, was actually a horrific recession of the gums! My teeth were killing me, I believe, due to the lower caninal parts, which heretofore had not "seen" the light of day, being exposed to the elements!
And, the bleeding of the gums did not help the persistent sore throat.
It was time to taper down and off, alas. Sigh. Sigh.
The sighs are because, after so many trials, I actually felt right ... even learned the word euthymic to rap the lingo with the pdoc!
My downfall may have been the accidental dosage increase mentioned above, but I'm not so sure. I had had a sore throat early on in my trial, but that went away when I was taking medication (antibiotic/antiviral) for something else.
I am very sensitive to meds, unfortunately. My conclusion is that one should just monitor this drug closely (as it is a drug). I myself would even consider re-visiting topamax in the future because it seemed to work so well as monotherapy for me, but for now, I am looking into lamictal or possibly adderal as my next monotherapy trial.
P.S. During the tapering off of topiramate, I once again experienced most of the cognitive difficulties that I had had titrating up! But now, they've all gone away as I am drug free and loving (NOT) it.
Best wishes to you all. Regards, phillybob.
Posted by Bob on March 5, 2001, at 1:56:48
In reply to Re: BAD Topamax Experiences? , posted by phillybob on March 4, 2001, at 23:27:39
> I feel like I was playin' a pinball game and now the "Game Over" is flashing.
>
> I had to discontinue the topiramate due to aforementioned bleeding gums which, it turns out, was actually a horrific recession of the gums! My teeth were killing me, I believe, due to the lower caninal parts, which heretofore had not "seen" the light of day, being exposed to the elements!
>
> And, the bleeding of the gums did not help the persistent sore throat.
>
> It was time to taper down and off, alas. Sigh. Sigh.
>
> The sighs are because, after so many trials, I actually felt right ... even learned the word euthymic to rap the lingo with the pdoc!
>
> My downfall may have been the accidental dosage increase mentioned above, but I'm not so sure. I had had a sore throat early on in my trial, but that went away when I was taking medication (antibiotic/antiviral) for something else.
>
> I am very sensitive to meds, unfortunately. My conclusion is that one should just monitor this drug closely (as it is a drug). I myself would even consider re-visiting topamax in the future because it seemed to work so well as monotherapy for me, but for now, I am looking into lamictal or possibly adderal as my next monotherapy trial.
>
> P.S. During the tapering off of topiramate, I once again experienced most of the cognitive difficulties that I had had titrating up! But now, they've all gone away as I am drug free and loving (NOT) it.
>
> Best wishes to you all. Regards, phillybob.Phillybob:
I am very sorry to see that you have had to stop the Topomax, despite the fact that it was giving you some good results. I too am getting some good results, along with some annoying ones. I am experiencing a frequent recurrence of sore throat, and a persistent skin problems - rash, and very dry sensitive skin. If I alter the dose of the medecine at all, such as taking it significantly early or late, or skip one altogether, then these effects become quite pronounced.
Anyway, trying Lamictal sounds like a good idea, but it can't be stressed enough that ramping up slowly is of paramount importance to avoid all chance of a rash. I think that they establishment is really on to something here with these new generation anti-seizure meds - they seem to be better in some ways than the SSRIs for some conditions.
Bob
Posted by o2manyfish on March 18, 2001, at 2:17:05
In reply to Topamax Experiences? (a.k.a. the longest thread), posted by phillybob on February 3, 2001, at 7:37:13
Hi There, I thought I would add some insight. I have been on Topamax for almost a year at 200mg a day. I was prescribed the Topamax to handle seizures and other problems created as a result of Encephalitis in the brain.
I had my first bout of Kidney stones after about 3 months on the Topamax. Then starting in September of last year the kidney stone occurrence became every 2 weeks. The Topamax has now damaged my kidneys.
Also as a result of the dry mouth I have ended up with severe peridontal damage on the jaw bone underneath the gum line.
I am now weaning myself off the Topamax and am trying to find a new anti-seizure medicine to supplement it. I can't continue treatment for any of my other issues until I am off the Topomax.
Other side effects I had with the Topomax included the inability to sleep regularly (2 hrs a night) until exhaustion set in, taste issues - I lost the ability to taste textures -- All sodas taste flat for example.
I am now down to 100mg of topamax everyother day and it barely maintains me on the edge of functionality and seizures.
Posted by Bob on March 18, 2001, at 9:34:30
In reply to Re: Topamax Experiences: Long Term Use, posted by o2manyfish on March 18, 2001, at 2:17:05
> Hi There, I thought I would add some insight. I have been on Topamax for almost a year at 200mg a day. I was prescribed the Topamax to handle seizures and other problems created as a result of Encephalitis in the brain.
>
> I had my first bout of Kidney stones after about 3 months on the Topamax. Then starting in September of last year the kidney stone occurrence became every 2 weeks. The Topamax has now damaged my kidneys.
>
> Also as a result of the dry mouth I have ended up with severe peridontal damage on the jaw bone underneath the gum line.
>
> I am now weaning myself off the Topamax and am trying to find a new anti-seizure medicine to supplement it. I can't continue treatment for any of my other issues until I am off the Topomax.
>
> Other side effects I had with the Topomax included the inability to sleep regularly (2 hrs a night) until exhaustion set in, taste issues - I lost the ability to taste textures -- All sodas taste flat for example.
>
> I am now down to 100mg of topamax everyother day and it barely maintains me on the edge of functionality and seizures.It's sounds like you've had a very hard time, and I'm sorry to hear that. What is the damage that is caused to your kidneys?
What side-effects do you experience as you taper down?
How severe are the kidney stones, is there any warning before their onset, and do they typically occur at the same time of day?
I've been on 200mg of Topomax for about 1.5 months now for depression. It seems to control my mood somewhat, some of the time. I gives me dry mouth, dry skin, tingling extremities, hypomanic episodes with increased doses, anger bouts with increased episodes, emotional lability, and God knows what else that I can't think of right now. The one major complaint I have with this med is that I have a moderate level of anxiety/raw nerves and seems to be missing a strong sense of relaxation of well-being. If I had to taper off of this though, I'd be going back on SSRI's, and there just not better than this so far.
Again, I'm sorry to hear about your situation.
Posted by Bob on March 19, 2001, at 23:08:13
In reply to Re: Topamax Experiences: Long Term Use, posted by o2manyfish on March 18, 2001, at 2:17:05
> Hi There, I thought I would add some insight. I have been on Topamax for almost a year at 200mg a day. I was prescribed the Topamax to handle seizures and other problems created as a result of Encephalitis in the brain.
>
> I had my first bout of Kidney stones after about 3 months on the Topamax. Then starting in September of last year the kidney stone occurrence became every 2 weeks. The Topamax has now damaged my kidneys.
>
> Also as a result of the dry mouth I have ended up with severe peridontal damage on the jaw bone underneath the gum line.
>
> I am now weaning myself off the Topamax and am trying to find a new anti-seizure medicine to supplement it. I can't continue treatment for any of my other issues until I am off the Topomax.
>
> Other side effects I had with the Topomax included the inability to sleep regularly (2 hrs a night) until exhaustion set in, taste issues - I lost the ability to taste textures -- All sodas taste flat for example.
>
> I am now down to 100mg of topamax everyother day and it barely maintains me on the edge of functionality and seizures.o2manyfish:
Could you please elaborate on how exactly the Topomax damaged your kidneys and the bone in your jaw for those of of who are taking comparable levels of the med? Needless to say, you have scared the you know what out of me! There is no evidence I have seen in the literature that Topirimate causes lasting permanent kidney damage, and you did not get specific about what happened to you.
Bob.
Posted by phillybob on March 20, 2001, at 0:34:43
In reply to Re: Topamax Experiences: Long Term Use, posted by o2manyfish on March 18, 2001, at 2:17:05
Hey, Bob! It looks like you can click on 02manyfish's name and email him directly (if it's a valid address). I'd be curious to know, too. When I was takin' it, I always drank LOTS of water (well, truth be told, I do that anyway).
Hope you are well. I meant to post sooner to say that your posts have been much more fluid which, to me, means you are feeling a bit better (than when I first recall your posts on this thread).
Regards, phillybob (formerly Topabob, currently Lamictabob)
Posted by Janice1 on March 20, 2001, at 18:19:06
In reply to Re: Topamax Experiences: Long Term Use, posted by o2manyfish on March 18, 2001, at 2:17:05
> I was very interested to hear your experience about your dry mouth and severe peridontal damage on the jaw bone underneath the gum line.
>
Since being on 100 mg of Topamax for about a year, I had 11 cavities at a dental check-up. I am awaiting my next check-up to see whether or not I will remain on the Topamax. I'm not willing to accept more than 1 or 2 cavities a year, at most. It's been great otherwise.Sorry for your experience,
Janice
Posted by Bob on March 20, 2001, at 19:33:48
In reply to Re: Topamax Experiences: Long Term Use, posted by phillybob on March 20, 2001, at 0:34:43
> Hey, Bob! It looks like you can click on 02manyfish's name and email him directly (if it's a valid address). I'd be curious to know, too. When I was takin' it, I always drank LOTS of water (well, truth be told, I do that anyway).
>
> Hope you are well. I meant to post sooner to say that your posts have been much more fluid which, to me, means you are feeling a bit better (than when I first recall your posts on this thread).
>
> Regards, phillybob (formerly Topabob, currently Lamictabob)Hey phillybob:
Yeah, I just may do that. This kidney damage thing has me worried.
So you're on Lamictal now? I tried that, but the rash stopped me. Between the dental problems and kidney problems though, I just may try a return to lamictal. The Topomax may be too hard to stay with. The cognitive dysfunction is getting on my nerves too. I'm tired of feeling dumb.
Refresh my memory... why did you finally quit the Topo?
Bob.
Posted by phillybob on March 20, 2001, at 20:02:52
In reply to Re: Topamax Experiences: Long Term Use, posted by Bob on March 20, 2001, at 19:33:48
> Refresh my memory... why did you finally quit the Topo?
Well, Bob, here's a cut and paste job for you:
"I had to discontinue the topiramate due to aforementioned bleeding gums which, it turns out, was actually a horrific recession of the gums! My teeth were killing me, I believe, due to the lower caninal parts, which heretofore had not 'seen' the light of day, being exposed to the elements! And, the bleeding of the gums did not help the persistent sore throat."
I was on 225 mg/day (with an accidental increase to 275 mg for the week preceding my problems) and I guess it was just too much for my body. It was nice, though, while it lasted.
Also, you might recall, I drank tons of water to help with the kidney issues (never had any) and took a B Complex "Stress" vitamin which helped greatly with the tingling AND the cognitive difficulties. I would revisit Topamax in the future, though at a lower dosage, if the Lamictal doesn't pan out. So far, so good; I'm takin' it much slower than the Topamax. I learned my lesson. Patience.
Posted by Bob on March 20, 2001, at 21:07:56
In reply to Re: Topamax Experiences: Long Term Use, posted by phillybob on March 20, 2001, at 20:02:52
> > Refresh my memory... why did you finally quit the Topo?
>
> Well, Bob, here's a cut and paste job for you:
>
> "I had to discontinue the topiramate due to aforementioned bleeding gums which, it turns out, was actually a horrific recession of the gums! My teeth were killing me, I believe, due to the lower caninal parts, which heretofore had not 'seen' the light of day, being exposed to the elements! And, the bleeding of the gums did not help the persistent sore throat."
>
> I was on 225 mg/day (with an accidental increase to 275 mg for the week preceding my problems) and I guess it was just too much for my body. It was nice, though, while it lasted.
>
> Also, you might recall, I drank tons of water to help with the kidney issues (never had any) and took a B Complex "Stress" vitamin which helped greatly with the tingling AND the cognitive difficulties. I would revisit Topamax in the future, though at a lower dosage, if the Lamictal doesn't pan out. So far, so good; I'm takin' it much slower than the Topamax. I learned my lesson. Patience.**************
Yes... patience is the key, although it's one of the things I'm short on, along with feelings of well-being. Any changes in dosage of the Topamax seem to be quite brutal for me - as in cold hands, tingling, anxiety, numbness, manic behavior, etc. It seems that more than one person on this list has experience kidney stones as well as gum/tooth and bone problems (even possible cavities with long term Topo use. I'm not so sure about this med any more. I'm thinking more and more about trying Lamictal again with a VERY slow titration rate. What kind of titration rate did you undertake out of curiosity? Did you get any sort of rash as you ramped up?
Posted by phillybob on March 20, 2001, at 22:21:39
In reply to Re: Topamax Experiences: Long Term Use, posted by Bob on March 20, 2001, at 21:07:56
> > What kind of titration rate did you undertake out of curiosity? Did you get any sort of rash as you ramped up?
I've barely titrated thus far with Lamictal which I'm trialing as monotherapy. 12.5 mg/day for about 10 days, now on 25 mg/day for almost a week. Tomorrow, gonna see the pdoc and probably move to 37.5 mg/day. I want to go real slow because I think I may have shot past my therapeutic dose with topiramate and, oh yeah, I'm weary of the rash. You can follow my trials (and Jah's too) here: http://www.dr-bob.org/babble/20010319/msgs/56941.html
Best wishes. As I posted in this thread, comin' off of topamax gave me most of the side effects I had in titrating up on the stuff. I liked the med, though. I was sayin' "euthymic." Now, I'm breathin'. I say there is a huge difference, but I think Lamictal has some promise for me (though, I'll say what I said early on with the Topamax: I might need to add something as an adjunct).
Posted by SLS on March 21, 2001, at 7:02:05
In reply to Re: Topamax Experiences: Long Term Use, posted by phillybob on March 20, 2001, at 20:02:52
Perhaps you can look into Gabitril (tiagabine). It is a relatively new anticonvulsant that I don't think I have seen anyone here try. It was mentioned as something to try by a doctor with whom I consulted last year. I suffer from bipolar depression. I have certainly placed it on my list, although I have not researched it enough to be comfortable to take it sight unseen.
- Scott
> Also, you might recall, I drank tons of water to help with the kidney issues (never had any) and took a B Complex "Stress" vitamin which helped greatly with the tingling AND the cognitive difficulties. I would revisit Topamax in the future, though at a lower dosage, if the Lamictal doesn't pan out. So far, so good; I'm takin' it much slower than the Topamax. I learned my lesson. Patience.
Posted by SLS on March 21, 2001, at 7:25:41
In reply to Re: Topamax Experiences: Long Term Use, posted by phillybob on March 20, 2001, at 22:21:39
Lamictal (lamotrigine) titration schedule for depression and bipolar disorder:
25mg x 2 weeks
50mg x 2 weeks
* (75 x 1 weeks)
100mg x 2 weeks
+50 x 1 week
Average dosage = 200mg
Range = 50mg - 300mg
(50mg does not usually provide the maximum relief)I have seen a few people taking 400mg, which is actually the average dosage for Lamictal when used in epilepsy.
I used a twice a day schedule.
e.g. 25mg = 12.5mg at breakfast and dinner.This is the schedule recommended to me when Lamictal is not being added to any other anticonvulsant. It is somewhat slower than that which is recommended in the PDR, because the PDR assumes that one is adding it to another anticonvulsant. The EXCEPTION is DEPAKOTE (valproate). The dosage of Lamictal MUST be reduced by 50%, and the titration schedule twice as slow.
* I stuck this in there for the hell of it. I guess if someone feels that they are particularly sensitive to Lamictal, it might make sense. Whenever I increased the dosage, I would feel some itching in my eyes that would disappear in one or two days. Without any data supporting the idea, I took this to be an indicator of my having a sensitivity to Lamictal, and that it gave evidence that the slower titration schedule chosen by my doctor was justified.
- Scott
Posted by Bob on March 21, 2001, at 21:36:48
In reply to Re: Topamax Experiences: Long Term Use, posted by phillybob on March 20, 2001, at 22:21:39
> > > What kind of titration rate did you undertake out of curiosity? Did you get any sort of rash as you ramped up?
>
> I've barely titrated thus far with Lamictal which I'm trialing as monotherapy. 12.5 mg/day for about 10 days, now on 25 mg/day for almost a week. Tomorrow, gonna see the pdoc and probably move to 37.5 mg/day. I want to go real slow because I think I may have shot past my therapeutic dose with topiramate and, oh yeah, I'm weary of the rash. You can follow my trials (and Jah's too) here: http://www.dr-bob.org/babble/20010319/msgs/56941.html
>
> Best wishes. As I posted in this thread, comin' off of topamax gave me most of the side effects I had in titrating up on the stuff. I liked the med, though. I was sayin' "euthymic." Now, I'm breathin'. I say there is a huge difference, but I think Lamictal has some promise for me (though, I'll say what I said early on with the Topamax: I might need to add something as an adjunct).****************
I wouldn't be suprised if I end up having to augment these antiseizure drugs with something else also (say, an SSRI?) Keep me posted as to how your Lamictal thing goes. It is disappoint to me, but not suprising to hear that all the side effects are experienced coming off medecine, the same as going on! Thanks for the link to your progress about Lamictal.
Bob
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