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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by sooshi on May 19, 2004, at 10:55:27
don't prescribe Zonegran more often? I know it's not as well known as the other anti-seizure/mood stabilizers, but it seems to be so effective (especially for me!), without all the horrendous side effects, especially compared to Topamax. Is it because of the sulfate allergy problem? Is it as effective for migraines, seizures and bipolar d/o as Topamax is? Why would a pdoc would choose Topa as a first-line defense against these disorders, with it's miriad of se's, when there are such drugs as Zonegran? Maybe it's too new. I have a feeling it has to do with $$?
Just curious.
Posted by chemist on May 19, 2004, at 14:32:17
In reply to Chemist...do you know why pdocs, posted by sooshi on May 19, 2004, at 10:55:27
> don't prescribe Zonegran more often? I know it's not as well known as the other anti-seizure/mood stabilizers, but it seems to be so effective (especially for me!), without all the horrendous side effects, especially compared to Topamax. Is it because of the sulfate allergy problem? Is it as effective for migraines, seizures and bipolar d/o as Topamax is? Why would a pdoc would choose Topa as a first-line defense against these disorders, with it's miriad of se's, when there are such drugs as Zonegran? Maybe it's too new. I have a feeling it has to do with $$?
>
> Just curious.hello there....topamax is a sulfamate, and the allergies to sulfites - found in foodstuffs such as wine to prevent oxidation of the vino - is not likely the cause, as the sulfamate anion interacts with the enzyme in question (carbonic anhydrase) and the presence of sulfate nor sulfite anions results. as to why doctors prefer it to zonegran, i can make 2 guesses: (1) it is a newer therapy (as you note) and it is not on the radar of many psychiatrists; and (2) there is a risk of SJS with zonegran that is not indicated with topamax, from what i have read.....all the best, chemist
Posted by sooshi on May 21, 2004, at 1:34:53
In reply to Re: Chemist...do you know why pdocs » sooshi, posted by chemist on May 19, 2004, at 14:32:17
Thanks Chemist! SJS is also a factor with Lamictal though, right? And it's prescribed big-time, so I didn't really consider that a factor. Oh well. I'm just feelin' so darn good on this stuff, and man, I haven't said that about a drug or myself in 15 years! I guess I just want to spread the good news, but I want to know WHY it's working and WHY nobody's using it!!
Anyway, thanks for all your contributions,
Sooshi
Posted by chemist on May 21, 2004, at 15:17:13
In reply to Re: Chemist...do you know why pdocs » chemist, posted by sooshi on May 21, 2004, at 1:34:53
> Thanks Chemist! SJS is also a factor with Lamictal though, right? And it's prescribed big-time, so I didn't really consider that a factor. Oh well. I'm just feelin' so darn good on this stuff, and man, I haven't said that about a drug or myself in 15 years! I guess I just want to spread the good news, but I want to know WHY it's working and WHY nobody's using it!!
>
> Anyway, thanks for all your contributions,
> Sooshihi sooshi...i am heartened by your experience, maybe the tide will turn....there is, as you note, a risk of SJS with lamictal...but it seems that many people get through the danger-stage by slowly titrating....in my opinion, the sooner lithium and depakote are put on the back-burner, the better! all the best, chemist
Posted by Viridis on May 22, 2004, at 6:05:04
In reply to Re: Chemist...do you know why pdocs » chemist, posted by sooshi on May 21, 2004, at 1:34:53
My understanding is that SJS is extremely rare with Lamictal, as long as it's titrated gradually. The initial trials simply had people taking too much too soon. SJS is also much more of a problem with children than adults. But of course, if you develop a rash after starting Lamictal, you should notify your doctor immediately and have it examined, just in case.
From what my pdoc has told me, SJS is very rare and preventable as long as you take it fairly slow with the dosage -- and it really doesn't take that long to reach a therapeutic dose anyway. It's not right for everyone (I experienced a bit of activation at first, and feel slightly agitated at over about 200 mg), but it can be very effective. As far as I can tell, most of the fears are unfounded, and just about any of these meds can be bad for some people.
I find Lamictal very subtle yet effective for mood swings, with no side effects (below 200 mg for me).
This is the end of the thread.
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