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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by tdaneen on January 12, 2001, at 9:55:56
Has anyone developed kidney stones after taking Topamax?
Looks like I just passed my first one last night. Not a
pleasant experience, believe me! Both my parents have had
kidney stones, and were informed that the succeptability
was genetic. Mom informed me of this after I had been on
Topamax for many months. I'm on 100mgs twice a day, and
it has been the only, and I mean ONLY medication that has
worked as a mood stabilizer for my BPII. It did take some
time to get to that dose, there were months of boosting
at 12.5mgs every two weeks or so just to keep the side
effects at a minimum. I wouldn't know what to do if I have
to give up this medication .
Has anyone else had these experiences? What else can be done,
other than drinking water to ward off kidney stones?Thanks, tdaneen
Posted by Bob on January 12, 2001, at 10:44:05
In reply to Topamax and Kidney stones..anyone, Cam?, posted by tdaneen on January 12, 2001, at 9:55:56
> Has anyone developed kidney stones after taking Topamax?
> Looks like I just passed my first one last night. Not a
> pleasant experience, believe me! Both my parents have had
> kidney stones, and were informed that the succeptability
> was genetic. Mom informed me of this after I had been on
> Topamax for many months. I'm on 100mgs twice a day, and
> it has been the only, and I mean ONLY medication that has
> worked as a mood stabilizer for my BPII. It did take some
> time to get to that dose, there were months of boosting
> at 12.5mgs every two weeks or so just to keep the side
> effects at a minimum. I wouldn't know what to do if I have
> to give up this medication .
> Has anyone else had these experiences? What else can be done,
> other than drinking water to ward off kidney stones?
>
> Thanks, tdaneenIf at all possible, you should get a stainer from your doctor and try to trap a kidney stone in your urine - especially if you get another one in the future. There are many different types, and Topomax tends to cause a certain kind, I believe. The stone can then be taken to a med lab and analzed for its chemical makeup. At least you could then have a better idea as to whether your instance would have been the Topomax or not. I got what was probably a kidney stone last year for the first time in my life last year, and would have to agree with you that it was a truly nasty experience. I'm also taking Topomax and hope very dearly that kidney stones aren't an inevitability in my future. I know what you are going through with that kidney stone. Its extremely unpleasant.
Posted by Bob on January 12, 2001, at 11:01:42
In reply to Topamax and Kidney stones..anyone, Cam?, posted by tdaneen on January 12, 2001, at 9:55:56
> Has anyone developed kidney stones after taking Topamax?
> Looks like I just passed my first one last night. Not a
> pleasant experience, believe me! Both my parents have had
> kidney stones, and were informed that the succeptability
> was genetic. Mom informed me of this after I had been on
> Topamax for many months. I'm on 100mgs twice a day, and
> it has been the only, and I mean ONLY medication that has
> worked as a mood stabilizer for my BPII. It did take some
> time to get to that dose, there were months of boosting
> at 12.5mgs every two weeks or so just to keep the side
> effects at a minimum. I wouldn't know what to do if I have
> to give up this medication .
> Has anyone else had these experiences? What else can be done,
> other than drinking water to ward off kidney stones?
>
> Thanks, tdaneentdaneen
could you possibly post more details about what you have tried before that hasn't worked, and how topomax has helped you? i'd be interested in hearing about that.
Posted by phillybob on January 12, 2001, at 12:15:50
In reply to Re: Topamax and Kidney stones..anyone, Cam? » tdaneen, posted by Bob on January 12, 2001, at 11:01:42
Hi, tdaneen. I shall be the control in our unscientific experiment. For the past 3 weeks, I have worked my way upwards of 125mg/day of Topamax but have neither prior personal nor family history of kidney stones. We shall see and hope that this shall not pass ...
As Bob has asked, please contribute your experiences of Topamax. But, could you do so, in our recently started thread (it currently shows above on this page. (this was the start of this particular thread: http://www.dr-bob.org/babble/20001231/msgs/50878.html). I have gone and attached a link to this kidney stone/topamax thread to that thread as well in attempting to keep topamax information in one spot for now ... I'm sure it's been attempted before, but alas, let me dream ... :)~
Posted by Cam W. on January 12, 2001, at 17:44:28
In reply to Topamax and Kidney stones..anyone, Cam?, posted by tdaneen on January 12, 2001, at 9:55:56
tdaneen - Ask your doc about taking sodium bicarbonate tablets. They can alkinize the urine and prevent stone formation, but they it can also change the excretion parameters of some drugs.
Hope this helps - Cam
Posted by stjames on January 12, 2001, at 19:58:44
In reply to Re: Topamax and Kidney stones..anyone, Cam? » tdaneen, posted by Cam W. on January 12, 2001, at 17:44:28
> tdaneen - Ask your doc about taking sodium bicarbonate tablets. They can alkinize the urine and prevent stone formation, but they it can also change the excretion parameters of some drugs.
>
> Hope this helps - Camjames here....
Amphetamine is one, so take note if you take Dexadrine of Adderal. This would cause an increase of amphetamine.
james
Posted by Sunnely on January 12, 2001, at 20:47:01
In reply to Topamax and Kidney stones..anyone, Cam?, posted by tdaneen on January 12, 2001, at 9:55:56
Hi tdaneen,
The good news about topiramate (Topamax) is that, among the anticonvulsants (mood stabilizers) currently in use in the US, Topamax appears to be least associated with weight gain, and, in fact, may be associated with weight loss in many patients.
The bad news is that, in epilepsy trials, 1.5% to 2.0% of Topamax-treated patients developed kidney stones. Although this incidence rate is considered to be low, the risk appears to be greater if you have: 1. personal history of kidney disease or kidney stones; 2. family history of kidney stones; and 3. hypercalciuria (elevated urine calcium). The risk also appears to be greater with: 1. increased dose of Topamax (but not duration of treatment); 2. in males between the ages of 21-54 years; 3. patients taking other carbonic anhydrase inhibitors like Topamax such as acetazolamide (Diamox) and zonisamide. While never been documented, for patients taking Topamax to lose weight, the risk of kidney stones may be increased further if they are also on a high-protein, "Atkins"-like diet, which promotes ketosis and therefore stone formation. To minimize this risk, patients are advised to avoid these types of diets and to increase their fluid intake.
Of note, 75% of Topamax-treated patients who develop kidney stones pass them spontaneously.
Further FYI. The following drugs/medical conditions can lead to increase urine calcium and subsequent kidney stone formation: 1. antacids; 2. diuretics such as furosemide (Lasix) and ethacrynic acid (Edecrin); 3. calcium supplement; 4. protein supplements; 5. corticosteroid treatment; 6. hyperparathyroidism (overactive parathyroid gland); 7. hyperthyroidism (overactive thyroid gland); 8. vitamin D toxicity; 9. certain bone diseases (tumor or malignancy).
Posted by Bob on January 13, 2001, at 0:33:13
In reply to Re: Topamax and Kidney stones..anyone, Cam? » tdaneen, posted by Sunnely on January 12, 2001, at 20:47:01
> Hi tdaneen,
>
> The good news about topiramate (Topamax) is that, among the anticonvulsants (mood stabilizers) currently in use in the US, Topamax appears to be least associated with weight gain, and, in fact, may be associated with weight loss in many patients.
>
> The bad news is that, in epilepsy trials, 1.5% to 2.0% of Topamax-treated patients developed kidney stones. Although this incidence rate is considered to be low, the risk appears to be greater if you have: 1. personal history of kidney disease or kidney stones; 2. family history of kidney stones; and 3. hypercalciuria (elevated urine calcium). The risk also appears to be greater with: 1. increased dose of Topamax (but not duration of treatment); 2. in males between the ages of 21-54 years; 3. patients taking other carbonic anhydrase inhibitors like Topamax such as acetazolamide (Diamox) and zonisamide. While never been documented, for patients taking Topamax to lose weight, the risk of kidney stones may be increased further if they are also on a high-protein, "Atkins"-like diet, which promotes ketosis and therefore stone formation. To minimize this risk, patients are advised to avoid these types of diets and to increase their fluid intake.
>
> Of note, 75% of Topamax-treated patients who develop kidney stones pass them spontaneously.
>
> Further FYI. The following drugs/medical conditions can lead to increase urine calcium and subsequent kidney stone formation: 1. antacids; 2. diuretics such as furosemide (Lasix) and ethacrynic acid (Edecrin); 3. calcium supplement; 4. protein supplements; 5. corticosteroid treatment; 6. hyperparathyroidism (overactive parathyroid gland); 7. hyperthyroidism (overactive thyroid gland); 8. vitamin D toxicity; 9. certain bone diseases (tumor or malignancy).Just out of curiosity... where did all that useful info come from?
Posted by Bob on January 13, 2001, at 0:38:10
In reply to Re: Topamax and Kidney stones..anyone, Cam? » tdaneen, posted by Sunnely on January 12, 2001, at 20:47:01
> Hi tdaneen,
>
> The good news about topiramate (Topamax) is that, among the anticonvulsants (mood stabilizers) currently in use in the US, Topamax appears to be least associated with weight gain, and, in fact, may be associated with weight loss in many patients.
>
> The bad news is that, in epilepsy trials, 1.5% to 2.0% of Topamax-treated patients developed kidney stones. Although this incidence rate is considered to be low, the risk appears to be greater if you have: 1. personal history of kidney disease or kidney stones; 2. family history of kidney stones; and 3. hypercalciuria (elevated urine calcium). The risk also appears to be greater with: 1. increased dose of Topamax (but not duration of treatment); 2. in males between the ages of 21-54 years; 3. patients taking other carbonic anhydrase inhibitors like Topamax such as acetazolamide (Diamox) and zonisamide. While never been documented, for patients taking Topamax to lose weight, the risk of kidney stones may be increased further if they are also on a high-protein, "Atkins"-like diet, which promotes ketosis and therefore stone formation. To minimize this risk, patients are advised to avoid these types of diets and to increase their fluid intake.
>
> Of note, 75% of Topamax-treated patients who develop kidney stones pass them spontaneously.
>
> Further FYI. The following drugs/medical conditions can lead to increase urine calcium and subsequent kidney stone formation: 1. antacids; 2. diuretics such as furosemide (Lasix) and ethacrynic acid (Edecrin); 3. calcium supplement; 4. protein supplements; 5. corticosteroid treatment; 6. hyperparathyroidism (overactive parathyroid gland); 7. hyperthyroidism (overactive thyroid gland); 8. vitamin D toxicity; 9. certain bone diseases (tumor or malignancy).This is definitely in keeping with the kidney stone I've ever had in my life. It was last year, long before I'd ever heard about Topomax, and at the end of about 1 year of taking the Fibercon type fiber supplement pills as a natural laxative to try and ease the ever-present constipation from the ADs I'd been taking. I got into the habit of taking quite a few per day - far more than recommended, and in addition to fiber, they contain calcium. I think I was ingesting large amounts of calcium. Eventually I precipitated a stone. My family has no history of stones whatsoever that I know of otherwise.
Posted by Sunnely on January 13, 2001, at 0:50:09
In reply to Re: Topamax and Kidney stones..anyone, Cam?, posted by Bob on January 13, 2001, at 0:33:13
> Just out of curiosity... where did all that useful info come from?
+++++++++++++++++++++++++++++++++++++++++++
Hi Bob,
Here are the references:
1. Topiramate-induced kidney stones in a patient with bipolar II disorder (Psychopharmacology Journal Watch). In: Primary Psychiatry, September 2000.
2. Bakerman's ABC's of Interpretive Laboratory Data, 3rd ed., 1994 by S. Bakerman, MD, P. Bakerman, MD, and Strausbauch P, MD. Published by Interpretive Laboratory Data, Inc., Myrtle Beach, SC.
Posted by tdaneen on January 14, 2001, at 12:25:08
In reply to Re: Topamax and Kidney stones..anyone, Cam? » Bob, posted by Sunnely on January 13, 2001, at 0:50:09
Well, I went to the Dr's office on Friday, and pee'd for him, and had X-rays. The good news is that he couldn't spot any more stones in the x-rays, and it doesn't look like I have an infection.
The information on 75% of patients who develop stones pass them spontanously could sound like what happened. BUT, aren't there some kinds of stones that don't show up in x-rays? I mean, non calcium stones?
Or, are the topomax stones mostly calcium based?thanks for the info! this has been a great thread.
tdaneen
Posted by Bob on January 14, 2001, at 13:05:50
In reply to Re: Topamax and Kidney stones..anyone, Cam?, posted by tdaneen on January 14, 2001, at 12:25:08
> Well, I went to the Dr's office on Friday, and pee'd for him, and had X-rays. The good news is that he couldn't spot any more stones in the x-rays, and it doesn't look like I have an infection.
> The information on 75% of patients who develop stones pass them spontanously could sound like what happened. BUT, aren't there some kinds of stones that don't show up in x-rays? I mean, non calcium stones?
> Or, are the topomax stones mostly calcium based?
>
> thanks for the info! this has been a great thread.
>
> tdaneenFrom what I've read about kidney stones... they can indeed be small enough to not show up in x-rays. I would think, however, that these would be the type that would be passed spontaneously. Did you get a strainer? Come to think of it, I think you can get a strainer at a well-equipped drug store. If you ever have another one and it's actually big enough to see, you can "capture" it and take it to the doctor.
Posted by tdaneen on January 14, 2001, at 15:12:41
In reply to Re: Topamax and Kidney stones..anyone, Cam?, posted by Bob on January 14, 2001, at 13:05:50
I really hope that is an experience I don't have to repeat. No, they didn't give me a strainer. I'll check into that, though. It wouldn't be a bad idea to have one on hand, just in case.
I really wouldn't want to have to pass a larger one, especially if I was in that much pain....eeek!
This is the end of the thread.
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