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Dr. Bob is Robert Hsiung, MD,
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Posted by Nickengland on August 19, 2005, at 4:35:01
In reply to Re: Topamax increase - Go Slow.... » Nickengland, posted by ClearSkies on August 18, 2005, at 19:31:13
Hi Clearskies
LOL...I peaked into your whine cellar yesterday ;-)
I've experienced, from what I can gather reading some of your posts recently, the same kind of things with increasing the Topamax...its really awful isn't it those side effect you get?
I can honestly say I've really had no problems at just 25mg...but when I started increasing it, thats when afew problems did arise (to complicate things even further, at the time of increasing I had a flu too!) but yeah, that feeling really tired during the day (but not being able to sleep) and then not sleeping to well at night was a pain in the *ss quite frankly!
I'm back at 25mg now, and things seem to be fine. I'm going to have another go soon at pushing it up (i'm actually prescribed 50mg a day) but if I dont see any benefits...i'll stick at 25 mg i think. At least that way its less side effects, less meds...etc..and it does do the job at this dose...for me so far, its been a couple of months.
I'm finding at times i have to watch myself for "aggression" too. But funnily enough i think this is something I can learn to control..and also I've sometimes been over sensitive before, so alittle extra agression in my case is quite healthy lol
Best of luck & lets keep those skies clear :-)
Kind regards
Nick
Posted by Nickengland on August 19, 2005, at 6:41:11
In reply to Re: Topamax increase - stupifying!, posted by Racer on August 16, 2005, at 12:23:31
Hi Racer,
>he said that the stupifying aspects could be controlled with an extra strength Maalox tablet
What is Maalox?..does it have to be prescribed from a doctor or is it a supplement?
Kind regards
Nick
Posted by Racer on August 20, 2005, at 12:47:39
In reply to Re: Topamax increase - stupifying! » Racer, posted by Nickengland on August 19, 2005, at 6:41:11
> Hi Racer,
>
> >he said that the stupifying aspects could be controlled with an extra strength Maalox tablet
>
> What is Maalox?..does it have to be prescribed from a doctor or is it a supplement?
>
> Kind regards
>
> NickIt's an over the counter antacid. Dr CattleProd said that the drug company representative told him that it's the bicarbonate that's the trouble, so Maalox, or even plain bicarbonate of soda would do the trick.
Of course, I haven't ever tried Topomax, but I do think Dr CattleProd knows his stuff, and I trust his advice well enough to try what he suggests.
Posted by ClearSkies on August 20, 2005, at 14:50:24
In reply to Re: Topamax increase - Go Slow.... » ClearSkies, posted by Nickengland on August 19, 2005, at 4:35:01
I am currently at 75mg/day and plan to stay at this dose as I seem to be feeling a bit better every day. I decided to take the larger "nighttime" dose at 3pm, and I stay awake during the afternoon, and am able to sleep at night better. Go figure... and I'm having some strange dreams lately, but I think some of them are due to the thunderstorms we've been having at night. (Don't ask!!)
p.s. I had been taking 25mg for 7 months and it was 3/4 of the dose my p-doc had intended for me to take.
ClearSkies
Posted by headachequeen on August 20, 2005, at 21:13:49
In reply to Re: Topamax increase - stupifying!, posted by Phillipa on August 17, 2005, at 19:25:02
> Funny I was reading a magazine and it stated Topamax was for migraine headaches? No other uses were mentioned. Fondly, Phillipa
Topamax is actually a med developed to be used as an antiepileptic but they discovered it had other uses.. its side effects work to help with migraines and it has been useful to deal with weight loss and in some people it helps with BiPolar as well as with mood disorder problems
kat
Posted by Phillipa on August 20, 2005, at 23:10:34
In reply to Re: Topamax increase - stupifying! » Phillipa, posted by headachequeen on August 20, 2005, at 21:13:49
What a great name! Maybe I should take topamax to help me lose the l0lbs I've gained since menopause is over and no more bioidentical hormones. Fondly,Phillipa
Posted by Nickengland on August 21, 2005, at 10:59:07
In reply to Re: Topamax increase - stupifying! » Nickengland, posted by Racer on August 20, 2005, at 12:47:39
Hi Racer,
Thanks for posting that, its something I wouldn't mind trying to see if it could possibly reduce side effects from Topamax. Sounds interesting...i'm going to have a look on the web to see if I can find some further information on how much you should take etc..
Only problem is lol I take Neurontin and Maalox has an interaction...
gabapentin and Al hydroxide/Mg hydroxide/simethicone (minor Drug-Drug)
Description:
Aluminum hydroxide and magnesium hydroxide antacids may decrease the bioavailability of gabapentin by as much as 20%. A dose of aluminum or magnesium hydroxide should precede a dose of gabapentin by at least two hours. Other antacids that contain aluminum or magnesium may interact with gabapentin in a similar fashion.Only a small interaction and I think gabapentin is mostly taken safe with everything...except Maalox LOL
Thanks for mentioning it though, and i'll see what I can find and may try it...
Kind regards
Nick
Posted by ed_uk on August 21, 2005, at 13:35:43
In reply to Re: Topamax increase - stupifying! » Racer, posted by Nickengland on August 21, 2005, at 10:59:07
Hi Nick,
The Maalox formulations in the UK don't contain sodium bicarbonate.
Kind regards
~Ed
Posted by headachequeen on August 21, 2005, at 13:54:17
In reply to Topamax increase - stupifying!, posted by ClearSkies on August 16, 2005, at 11:19:20
> I'm in the process of increasing my Topamax dosage from 25mg/day to 100mg/day as I've been having trouble with irrational and racing thoughts. I've been taking it slowly , just having finished a week at 50mg, and yesterday was my first 75mg day. Today I am in a complete stupor. I'm quite weak limbed, certain that I can drop off to sleep with no difficulty, and I think the only reason I don't have any irrational thoughts is because I'm too darn tired to create any thoughts at all.
> The dosage is broken up like this: 25mg upon waking, and 50mg at night. I am having troube falling asleep - no doubt because I'm getting all my winks during daylight.
> Am I turning into a vampire? Will I adjust, should I change the times I take the medication? Caffiene is of no help to me, it just makes me irritable and jumpy, but still tired.
>
> Any suggestions are appreciated.
> Other meds taken are 60mg Cymbalta at night, .5mg xanax as needed for anxiety and panic, and 10mg Ambien for sleep. My dx is bipolar2, GAD, and panic attacks.
> Thanks!
> ClearSkiesFor some reason my computer and I have not been in proper synch with each other; I think it needs some sort of help... and topomax is not going to be the help it needs...
at any rate, I am suddenly getting topamax messages days after they are posted....Clearskies.. I do like that name and I wish you days and days of nothing but clear skies...
you are increasing your dosage much too quickly, hence the stupor and fatigue...topamax is meant to be increased over longer periods of time... with two weeks at least between increments...
any shorter period of time means that you are ganging up on your system and your body simply cannot cope....
when I started taking topamax, the neurologist gave me a timetable that stressed the two week intervals as being a recommended guideline, one was to increase the dosage only if one's body was ready for it... if necessary one could take three weeks or longer before the next increase...don't rush the increments, let your body adjust to 25 mg then move up to 50 and so on...
many people find it easier on themselves to adjust by 12.5 mg at a time and over the three week period...a week is definitely not enough time no matter what the dose...
kat
Posted by ClearSkies on August 21, 2005, at 16:23:49
In reply to Re: Topamax increase - stupifying! » ClearSkies, posted by headachequeen on August 21, 2005, at 13:54:17
Thanks so much!! I read your post on the thread further above and clued in that I was going too quickly on the titration.
I'm feeling much more "with it".
ClearSkies
Posted by Nickengland on August 21, 2005, at 17:42:58
In reply to Re: Topamax increase - stupifying! » Nickengland, posted by ed_uk on August 21, 2005, at 13:35:43
Hi Ed,
I see, so Maalox would not help, using a UK version..Thanks for letting me know Ed :-)
Have you heard of bicarbonate being used with Topamax to reduce cognitive effects, or the cognitive effect being caused because of bicarbonate?...can you see a link here? i was unable to find anything on the web about it so far.
Kind regards
Nick
Posted by Nickengland on August 21, 2005, at 17:43:43
In reply to Re: Topamax increase - stupifying!, posted by Nickengland on August 21, 2005, at 17:42:58
Posted by headachequeen on August 21, 2005, at 17:51:18
In reply to Re: Topamax increase - stupifying! » headachequeen, posted by ClearSkies on August 21, 2005, at 16:23:49
> Thanks so much!! I read your post on the thread further above and clued in that I was going too quickly on the titration.
> I'm feeling much more "with it".
> ClearSkiesToo often we are given too little information about the medications we are told to take...
and then when we have problems with the side effects we quit taking the meds that might have helped us had we been properly prepared for them...
other times we are given meds with no proper background and are not prepared for the devastating properties or for the potential chaos when two meds clash...
that is one of the benefits of places such as this board where we can ask questions of people who have actually experienced the medication...
the risk is to read the negative effects from someone who took it and quit without trying to work things out...
for instance a person who titrated up too fast or, like me, who didn't read the directions and started with morning dosages and was so nauseated it was really devastating... my own fault... and when I read the directions and started over, everything worked rather well...I do have problems, though, with doctors who do not learn about new medications that render old work horse medications obsolete, especially when those older meds have really horrendous side effects...
some on this list pointed out that in the UK topamax is used on its own to combat epilepsy and that gave me the ammunition I needed.
I am now rid of the really dangerous med and doing much better with just topamax...
turns out the tegretol was causing seizures... and is known to do that...
someone had to do his homework....
thank heaven someone here did!!!!!
kat
Posted by headachequeen on August 21, 2005, at 17:52:39
In reply to Re: Topamax increase - stupifying!, posted by Nickengland on August 21, 2005, at 17:42:58
> Have you heard of bicarbonate being used with Topamax to reduce cognitive effects, or the cognitive effect being caused because of bicarbonate?...can you see a link here? i was unable to find anything on the web about it so far.
>
> Kind regards
>
> Nick
>
Nick, this is something I have not heard of...
but going to ask...meanwhile, thank you for information that has made life a lot better...
kat
Posted by Nickengland on August 22, 2005, at 6:19:53
In reply to Re: Topamax increase - stupifying! » Nickengland, posted by headachequeen on August 21, 2005, at 17:52:39
You're very welcome Kat,
Not sure if I deserve the thanks though lol - it was Racer who provided the information about bicarbonate...
I'm very interested to find out this myself too ~ I know that since taking Topamax my metabilism has changed ~ sped I think. Basically i'm processing food differently, which must be the way that Topamax makes you lose weight. I havent really had any problems with cognitive effects that are enough to cause me concern. I'm interested in this bicarbonate, to see whether it can reduce any of the existing side effects I have and to see chemically what the link is. The only side effects I have are mild, but of course if I can reduce them, that'll be great and I guess for others too..
Kind regards
Nick
Posted by headachequeen on August 22, 2005, at 9:24:41
In reply to Re: Topamax increase - stupifying! » headachequeen, posted by Nickengland on August 22, 2005, at 6:19:53
> You're very welcome Kat,
>
> Not sure if I deserve the thanks though lol - it was Racer who provided the information about bicarbonate...
>
> I'm very interested to find out this myself too ~ I know that since taking Topamax my metabilism has changed ~ sped I think. Basically i'm processing food differently, which must be the way that Topamax makes you lose weight. I havent really had any problems with cognitive effects that are enough to cause me concern. I'm interested in this bicarbonate, to see whether it can reduce any of the existing side effects I have and to see chemically what the link is. The only side effects I have are mild, but of course if I can reduce them, that'll be great and I guess for others too..
>
> Kind regards
>
> Nick
I was referring to the information about topamax being used as a sole therapy for epilepsy...
that information has made a huge difference for me...
absolutely huge...
kat
Posted by Nickengland on August 22, 2005, at 15:16:06
In reply to Re: Topamax increase - stupifying! » Nickengland, posted by headachequeen on August 22, 2005, at 9:24:41
Hello Kat
Ahh I see my applogies :-)
I'm very glad to see the success you have with Topamax for Epilepsy. I am finding it a very good drug to use too.
I was using Tegretol before topamax too and find topamax so much more helpful.
What type of Epilepsy to have?
Kind regards
Nick
Posted by ed_uk on August 22, 2005, at 15:46:24
In reply to Re: Topamax increase - stupifying!, posted by Nickengland on August 21, 2005, at 17:42:58
Hi Nick,
>Have you heard of bicarbonate being used with Topamax to reduce cognitive effects.........
Topamax can occasionally cause a condition called metabolic acidosis. Your doctor can test for this. Bicarbonate tablets are used to treat metabolic acidosis. Don't take bicarbonate tablets unless you've developed metabolic acidosis. Topamax often causes mild metabolic acidosis but severe metabolic acidosis is rare. If you had developed severe metabolic acidosis you'd be very ill! Mild metabolic acidosis can be difficult to recognise without a blood test. The risk of metabolic acidosis increases as the Topamax dose is increased.
Sodium bicarbonate caps/tabs are available on prescription. Potassium bicarbonate is also available.
Metabolic acidosis can only be diagnosed by a blood test.
Symptoms of mild metabolic acidosis are vague........
Headache
Nausea/vomiting
Reduced appetite
Deep and/or rapid breathing
Lethargy
Cognitive impairment
.............of course, all of these symptoms can occur in the absense of metabolic acidosis.Kind regards
~Ed
Posted by ed_uk on August 22, 2005, at 15:49:12
In reply to Re: Topamax increase - stupifying!, posted by Nickengland on August 21, 2005, at 17:42:58
If your doctor is not aware of the link between Topamax and metabolic acidosis...... here is some education ;-)
The offical Canadian warning:
http://www.hc-sc.gc.ca/dhp-mps/medeff/advisories-avis/public/2004/topamax_3_pa-ap_e.html
~ed
Posted by headachequeen on August 22, 2005, at 16:29:33
In reply to Re: Topamax increase - stupifying! » headachequeen, posted by Nickengland on August 22, 2005, at 15:16:06
> Hello Kat
>
> Ahh I see my applogies :-)
>
> I'm very glad to see the success you have with Topamax for Epilepsy. I am finding it a very good drug to use too.
>
> I was using Tegretol before topamax too and find topamax so much more helpful.
>
> What type of Epilepsy to have?
>
> Kind regards
>
> Nick
Salut Nick!I guess if one were to pin it down, I would be classed as having tonic clonic...
I suffered a brain injury at birth with the left templar lobe and the frontal lobe affected...
my doctor informs me that the situation is relatively rare but that he would expect nothing less from a redhead ... sigh...
As a rule the seizures are nocturnal, sometimes with the rhythmic leg and arm movements and other times with a rigid sort of reaction when I seem to be unconscious for a period of time and no one is able to recall me to consciousness until the seizure leaves me, no movement or jerking of limbs involved...
those seizures leave me in a limbo afterwards; when I waken I relive the day previous until something calls the actual day to my attention, so that I sometimes stay on one day for several days at a time... it can be truly confusing...
and exhaustingfor several months following tests ordered by a neurologist my seizures switched to daytime and were absolutely awful, as the tegretol increased the duration and the strength of the seizure...
I have often wondered how people endure that type of seizure.. I had a chance to learn first hand and frankly I would rather have gone on wondering...
it took a year to regain the balance and normalcy of my own pattern so to speak and then the neurologist wanted to do it all over again...
I have been postponing the test ... want to keep the neuro in case I need him but do not want to create that horrid imbalance in my life again, especially now that I have managed to achieve this calm with the tegretol gone...
amazing how quickly we come to enjoy a peaceful existencekat
Posted by ed_uk on August 23, 2005, at 16:24:58
In reply to Re: Topamax increase - stupifying! » headachequeen, posted by Nickengland on August 22, 2005, at 15:16:06
Hi!
Did you see my posts to you above?
Kind regards
~ed
Posted by stresser on August 23, 2005, at 21:53:45
In reply to Re: Topamax increase - stupifying! » Nickengland, posted by headachequeen on August 22, 2005, at 16:29:33
We're doing fine with the topomax here...but I am wondering about something with Nick. How long have you been taking it? I haven't gone back through all of the posts to check to see how long. I went up very slowely, and didn't have any cognative problems. ( that I know of) -L
Posted by Nickengland on August 24, 2005, at 14:19:36
In reply to Re: Topamax increase - stupifying! » Nickengland, posted by ed_uk on August 22, 2005, at 15:46:24
Hi Ed,
I remember when I first starting taking Topamax and read through the list of the side effects, metabolic acidosis was one in particular that caught my eye. (sounded quite serious :-o) That and the kidney stones..
>Don't take bicarbonate tablets unless you've developed metabolic acidosis.
Sounds sensible to me :-)
>Metabolic acidosis can only be diagnosed by a blood test.
I remember my GP when he first gave me Topamax reading through the list of side effects, he didn't mention that one in particular, but he did reassure me in a sense that this drug would be alot safer taking longterm than compared with lithium for example. He didn't mention blood tests and as far as I know my psychiatrist hasnt as of yet (I'm his first patient on topamax lol) maybe i'll remind him of this side effect and also enquire about whether a blood test should be done to check electrolytes etc and this specific side effect before I go to Australia.
As far as I know this kind of blood test doesnt have to be done routinely like with carbamazepine or lithium does it?..I have read elsewhere on the web though and I think even on the Topamax website the mention that your doctor may want to *occasionally* do a blood test just to check things are okay?
>Symptoms of mild metabolic acidosis are vague........
>Headache
No headaches whatsoever! :)
>Nausea/vomiting
All fine there
>Reduced appetite
Kind of, but I can still eat okay.
Deep and/or rapid breathing
Possibly the oppisite as i'm calmer lol
Lethargy
LOL always!
>Cognitive impairment
I'm fine there so far :-)
Kind regards
Nick
Posted by Nickengland on August 24, 2005, at 14:21:46
In reply to Topamax can cause metabolic acidosis » Nickengland, posted by ed_uk on August 22, 2005, at 15:49:12
Hi Ed,
That you for the education ;-) LOL
Seriously i'm glad you showed me that, I may actually have to educate my psychiatirst on this - it wouldn't be the first time ive had to teach him something! lol
Kind regards
Nick
Posted by Nickengland on August 24, 2005, at 14:27:18
In reply to Re: Topamax increase - stupifying! » Nickengland, posted by headachequeen on August 22, 2005, at 16:29:33
Hi Kat,
I'm very glad to hear you now have managed to achieve such a good recovery with the aid of Topamax from those seizures...
>when I waken I relive the day previous until something calls the actual day to my attention, so that I sometimes stay on one day for several days at a time... it can be truly confusing...
and exhaustingI can only imagine, that sounds very exhausting :( Do you still go through this since you've been on Topamax?...or have you been more or less seizure free so to speak since you started topamax?
Kind regards
Nick
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