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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 7 of 7. This is the beginning of the thread.
Posted by dddiane on April 19, 2003, at 15:51:19
I've been taking Topamax as a mood stablizer since late November, I am bipolar, and it has been a great medication for me, very effective. After a couple of months I adjusted to the cognitive stuff, and though I'll never get used to the dry mouth, I can live with it.
But this is the wierd thing. At 100mg I felt great. My mania was under control, though I still had a touch of depression. Then I had to bump up to 125mg to keep the mania under control. That worked for a couple of months. Then the depression ceased to be a problem. That was great. Then I had a sudden manic break through. 150mg brought it back under control and I felt peaceful again. For two weeks. Now I'm at 175mg and I'm wondering if I'm going to have to go up to 200mg in a week or two, because my sleep is getting a little dicey and I'm feeling a little "speedy" again.
This is very odd to me because I was stable, maybe a little hypomanic, but stable at the same dose of Tegretol for many years. I had to quit Tegretol because of hyponatremia and rash.
I have been taking Topamax for over five months now and when it is working, which is most of the time, it works so well. I'm very productive at my job, my depression is gone, and I'm happy. Nothing has worked this well. It is just puzzeling to me how a certain mg works for a while, and then it just isn't enough anymore.
Has anyone else had this happen? What is an effective dose for other people here with bipolar? I am a bipolar I who tends to hang out on the manic end of the scale when under medicated.
Thanks!
Diane
Posted by judy1 on April 19, 2003, at 16:34:29
In reply to Topamax - has this happened to you?, posted by dddiane on April 19, 2003, at 15:51:19
Hi Diane,
I also am dxed bp1 and tend to be more on the manic side. Are you a rapid cycler? I am, and have run the gamut of mood stabilizers (including topamax) and various combinations, and have never achieved true stability. I think there may be a subset of people with this disorder who have to treat specific episodes, and that is what I do- usually depakote works well (and zyprexa if it's really bad). Once the episode is over I'm off the medication and maybe 4 months go by before another episode (I usually crash after the mania, but use therapy and opiates to treat the depression). Obviously this isn't the perfect solution, but it's the only one that works for me- and I'm hoping one day the episodes will be less frequent and that will mean no meds. best of luck (and I wish I could have helped more)-judy
Posted by dddiane on April 20, 2003, at 8:45:32
In reply to Re: Topamax - has this happened to you? » dddiane, posted by judy1 on April 19, 2003, at 16:34:29
Judy,
Thanks for your response. I'm still trying to achieve stability, but I do have to treat the episodes within that. And as much as I dislike the neuroleptics I'll use them when manic to come down.
I know Depakote can be effective, but I stay away from it now. Too much hair loss.
I guess for now I'll hang in there with Topamax and hope that 175mg holds me.
Diane
Posted by audrey on April 22, 2003, at 15:46:59
In reply to Topamax - has this happened to you?, posted by dddiane on April 19, 2003, at 15:51:19
Hi Diane,
I too am bi-polar, and tend to rapid cycle. I never know when I'm going to freak out or when I'm going to sink really low. I was on Depakote for a while, and it seemed to do a pretty decent job maintaining my moods, with a little slip here and there, but I gained a lot of weight, and that caused a whole other set of issues. So my pdoc put me on Topomax about 4 months ago, per my request, since I've tried everything else, it seems. I'm up to 150mg now, and although it's better than nothing, it's not as effective as the Depakote. I seem to have a real problem with depression, but a manic episode slips in every once in a while (a couple of nights ago I was pulling all of my books off my bookshelves -- I won't get into why...). I have Zyprexa that I can take when I start freaking out, but the depression stuff is difficult to deal with. My pdoc doesn't want to give me an AD just in case it causes me to slip more into mania, so I'm just trying to hang in there.So that's my story with Topamax. I hope the higher dose works out for you. It's incredibly frustrating dealing with this!! Good luck -- I'd like to hear how things go for you in the future.
--Audrey
Posted by dddiane on April 22, 2003, at 17:13:01
In reply to Re: Topamax - has this happened to you?, posted by audrey on April 22, 2003, at 15:46:59
Audrey,
Thanks for your response. It makes me feel a little less alone in this. Last summer I was tapering off of Depakote due to hair loss. And at a relatively low dose felt kind of stable. But I had also gained weight from psych meds and that 20 lbs wasn't going anywhere while I was on Depakote. And the amazing hair loss was unacceptable. :(
Topamax, sometimes I love it sometimes I'm underwhelmed. Maybe it's just this bipolar thang that is so frustrating.
Almost as soon as I posted the message above I find myself on a slight downturn. Well, at least I'm catching up on sleep I was missing!
I too have an AP in my "med bag" for my manic moments. Respirdal. I used to take it as a maintenence med. Hated it, I swear it made me depressed. But once I went off it my pdoc told me to "keep it in my back pocket" (her words) for those bad days. So I did, and it has helped me over the bad patches (mania).
How long have you been on Topamax? I had depression with it for the firsrt few months, but not any longer, not like at first. I did read that depression was an early side effect. It did seem to lift for me, but I don't know if that is due to aujusting to Topamax or to spring and more light?
You can always find me over at http://pub123.ezboard.com/btopamaxtalk
under the same name. But I'll be here too. Geez, I wish I was pulling all the books off my shelves, lol, my mania is more like angry letters to the editor and trying to get myself fired!!!Diane
Posted by audrey on April 23, 2003, at 12:54:50
In reply to Re: Topamax - has this happened to you? » audrey, posted by dddiane on April 22, 2003, at 17:13:01
That's amazing, Diane -- I know exactly how you feel! And as unfortunate as it is that we have to go through this, it is reassuring to know that there is someone out there that has some idea of what it is like.
I'm actually thinking of quitting my job on Friday -- my boss is on vacation until then, and I've really just had it. I've got nothing else lined up, but I don't care! Getting fired would actually be great, though! Any suggestions? Normally I wear my nice little trousers or skirts and dress shoes, but today I wore a pair of those red shoes that look like bowling shoes. It won't get me fired -- it's just a little rebellion, but it feels good! My most recent really psychotic action was a couple of months ago when it was about 15 degrees outside here in Boston, and my husband and I were going to drive out to the 'burbs to do some shopping. I started freaking out because of traffic and decided I couldn't deal with it, so while we were stopped at a traffic light I jumped out of the car -- no keys, no coat, no money -- and just started walking like a mad woman across Boston Common. Yeah, people were looking at me like I was pretty crazy. Fortunately Boston is a small city, so it didn't take too long to walk home. And I've written my share of letters to the editor, especially lately!
Anyway, I'll have to check out the site you refer to. In the meantime, hang in there!
Take care,
Audrey
Posted by dddiane on April 25, 2003, at 6:45:32
In reply to Re: Topamax - has this happened to you? » dddiane, posted by audrey on April 23, 2003, at 12:54:50
Audrey,
I love the shoes! I did something similar, except my job is very laid back and normally I wear nice jeans, so instead I wore job hunting clothes and asked for a raise! I got it too! But then the following week my self-righteous anger had evaporated and I was back in my shell, my boss was irritated with me for making a week's worth of demands on him and that was tough to deal with. But he got over it and I still have to raise :).
That's why they call it manic depression!
Good talking to you,
Diane
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