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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by SLS on August 1, 2006, at 16:37:05
I am currently taking Topamax at a dosage of 150mg to treat bipolar depression. Any thoughts as to how high I should go?
- Scott
Posted by maxime on August 1, 2006, at 21:51:46
In reply to Topamax dosage?, posted by SLS on August 1, 2006, at 16:37:05
> I am currently taking Topamax at a dosage of 150mg to treat bipolar depression. Any thoughts as to how high I should go?
>
>
> - ScottAre you feeling any relief from the dosage you are currently at?
When I was on it, my pdoc was aiming for a dosage of 150 mg.
:( Sorry I am not much help.
Hugs, Maxime
Posted by SLS on August 2, 2006, at 0:14:11
In reply to Re: Topamax dosage? » SLS, posted by maxime on August 1, 2006, at 21:51:46
Hi Maxime.
Thanks for responding.
> > I am currently taking Topamax at a dosage of 150mg to treat bipolar depression. Any thoughts as to how high I should go?
> Are you feeling any relief from the dosage you are currently at?
I started feeling an improvement in mental energy and concentration at 50mg. It was very, very slight, but noticeable. I have experienced no further improvements, but seem to have maintained a residual of what I gained at 50mg. I know one person who had been as high as 400mg, but this was done in an attempt to control mania. 200mg seems to be as good as 400mg for this. I think I would prefer to be at 100mg. Although I don't seem to be experiencing any cognitive side effects, I do experience muscle weakness and breathlessness upon exertion.
> When I was on it, my pdoc was aiming for a dosage of 150 mg.What made you stop?
- Scott
Posted by Maxime on August 2, 2006, at 14:05:07
In reply to Re: Topamax dosage?, posted by SLS on August 2, 2006, at 0:14:11
When I was on it, my pdoc was aiming for a dosage of 150 mg.>
> What made you stop?
>
>
> - ScottI went psychotic. Tried it a second time with a different pdoc ( I told it had made me psychotic before) and guess what? ... I went psychotic and landed in the hospital for a week. I suffered extreme paranoia and auditory hallucinations.
It also gave me very bad acne.
So that was the end of my Topomax experience.
Yours sounds much better. :)
Hugs,
Maxime
Posted by ledgermike on August 3, 2006, at 22:19:52
In reply to Re: Topamax dosage? » SLS, posted by Maxime on August 2, 2006, at 14:05:07
Hi Scott, I initially went on Topamax for migraine and headaches and it has worked wonderfully for that but as a side effect I noticed an immediate improvement in my BP II symptoms. Due to sleepiness, I am unable to tolerate taking it during the day so I have to take 100 mg at night. At first I was anxious to increase the dosage but my doc preached patience and I have to admit that he was probably right. I am very happy were I am at right now. Let me know if you have any questions.
Posted by SLS on August 4, 2006, at 4:44:36
In reply to Re: Topamax dosage?, posted by ledgermike on August 3, 2006, at 22:19:52
Hi.
Thanks for taking the time to respond.
> Hi Scott, I initially went on Topamax for migraine and headaches and it has worked wonderfully for that but as a side effect I noticed an immediate improvement in my BP II symptoms. Due to sleepiness, I am unable to tolerate taking it during the day so I have to take 100 mg at night. At first I was anxious to increase the dosage but my doc preached patience and I have to admit that he was probably right. I am very happy were I am at right now. Let me know if you have any questions.
What aspects of your BP do you feel that Topamax improved? I am really in need of something to target depression.
- Scott
Posted by TJO on August 4, 2006, at 5:09:16
In reply to Re: Topamax dosage? » ledgermike, posted by SLS on August 4, 2006, at 4:44:36
Hi Scott,
I take 100 mg of Topamax (this post is mostly for the rest of the board-you know already). It has improved my functioning a lot. I recognize my mood swings now, catch that I sometimes leave out important words in conversation, can think a lot more clearly, and feel it has helped somewhat with the emotional regression I experienced at the start of the illness. There are other things too, but this is all of what I can think of right now. It is as if the feedback loop in the brain (if there is one) towards getting well has been triggered and the one towards getting sicker has been stopped. There is a fine line I think between taking too little and taking too much and taking any more than 100 mg for me might be too much, and maybe even 75 mg at a lower weight would be the right dosage. I feel as if I can think again, somewhat normally, and I havent been able to really do that well since about 1992, or so. The weight loss is a nice side effect too :-).Tammy
Posted by TJO on August 4, 2006, at 5:13:46
In reply to Re: Topamax dosage?, posted by TJO on August 4, 2006, at 5:09:16
Here's some info on the dosage of Topamax:
Topamax's Dosage and How to Take Topamax: The initial dose of Topamax (topiramate)is 25-50mg a day, increased by 25-50mg a day each week as needed until you reach the maximum of 400mg a day. Usually divided into two doses, but you can often get away with taking it all at night. Topamax's half-life and peak-plasma figures will let some people get away with taking it all at night, but it all depends on your pattern of seizures and how the med works out for you. In this respect Topamax (topiramate)is flexible. You and your doctor can play around with the scheduling of your doses. Although rated for 1,000mg a day in cases of extreme seizures, Ortho-McNeil has found little in the way of therapeutic value above 400mg a day.
from:
http://www.crazymeds.org/topamax.html
Tammy
Posted by TJO on August 4, 2006, at 5:17:35
In reply to Re: Topamax dosage?, posted by TJO on August 4, 2006, at 5:13:46
As a bipolar medication it depends on what flavor of bipolar you have. In Bipolarland you don't always need the full 400mg a day, and you can often get away with taking it all at bedtime. However, if you're subject to ultradian rapid cycling (where you flip between extremely manic and severely depressed several times a day, even several times an hour) as I am, it's best to take 25-50mg first thing in the morning, 25-50mg in the afternoon, and the balance of your dosage at bed time. If you have any breakthrough periods of ultradian rapid cycling, talk to your doctor about taking an extra 25mg of Topamax (topiramate)every hour on the hour until you're ready to go to sleep that day. You'll find the ultradian rapid cycling abates pretty damn fast that way, sometimes in a matter of three or four hours.
As always I'm for a slow titration. Unless you're seriously flipping out or seizing all over the place, start at 25mg and increase by 12.5 to 25mg a day each week as required until both symptoms and side affects abate. Topamax (topiramate)is extremely dosage sensitive and you'll find that side effects will actually decrease in intensity, if not go away, once you hit your proper dosage. So as odd as that reads, it will take an increase in your dosage for some side effects to go away. Presuming, of course, that Topamax (topiramate)is the right medication for you.
from:http://www.crazymeds.org/topamax.html
Tammy
Posted by ledgermike on August 4, 2006, at 15:58:36
In reply to Re: Topamax dosage? » ledgermike, posted by SLS on August 4, 2006, at 4:44:36
> Hi.
>
> Thanks for taking the time to respond.
>
> > Hi Scott, I initially went on Topamax for migraine and headaches and it has worked wonderfully for that but as a side effect I noticed an immediate improvement in my BP II symptoms. Due to sleepiness, I am unable to tolerate taking it during the day so I have to take 100 mg at night. At first I was anxious to increase the dosage but my doc preached patience and I have to admit that he was probably right. I am very happy were I am at right now. Let me know if you have any questions.
>
> What aspects of your BP do you feel that Topamax improved? I am really in need of something to target depression.
>
>
> - ScottI have been treated primarily for depression all my adult life. The side effects of the various medications I have taken would cause me to stop taking them until I was in danger of doing something regrettable. I found a Dr. who suggested that I might be a "hiding" BP due to my natural shyness/introversion. I have suffered from withering headaches all my life, so my treatment started from there. I started at 25mg and moved up by 12.5mg every 2 weeks. I felt horrible splitting my dose so he told me to try taking it all at night and that has worked well. I am at work so I will give you good and bad. Good: Virtually no headaches, depression has lifted, and anxiety/agitation has disappeared. I have no urge to drink alcohol/ drive real fast/ play online poker. Bad: Indigestion /tingling- pins and needles especially in feet/ cognitive issues- stressful at first but once I relaxed it got better. I skimmed quite a bit so feel free to ask any question. Quick answer- yes it really targeted my depression-my primary demon.
Mike
Posted by SLS on August 5, 2006, at 9:02:58
In reply to Re: Topamax dosage?, posted by ledgermike on August 4, 2006, at 15:58:36
Hi.
After describing my response to Topamax beginning at 50mg and progressing through 150mg, my doctor did not think there would be any added benefit from increasing the dosage further. I am decreasing the dosage to 100mg to see if I retain the improvement at the lower dosage so that I can reduce the risk of developing kidney stones. It is a dosage-dependant side effect.
- Scott
This is the end of the thread.
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