Topamax Effects During Alcohol Withdrawal Stages
As of yet, researchers are unsure about how Topamax helps to reduce alcohol cravings and support abstinence measures, though specific brain chemical interactions seem to be affected in the process. When ingested, Topamax affects how the brain produces certain neurotransmitter chemicals, two of which are GABA and dopamine. Not surprisingly, these are the same two chemical processes most affected by ongoing alcohol use.
Treatment for alcohol dependency involves a two-phase process, which includes the withdrawal phase and the relapse prevention phase. Topamaxs chemical effects appear to work best during the early stages after a person has just stopped drinking.
Clinical studies appearing in BMC Psychiatry show low doses of Topamax to be effective at treating alcohol cravings at the start of the withdrawal phase. Topamax also fares well in reducing the anxiety and depression symptoms that often occur during withdrawal.
Can Topamax Help Depression
Though a few small studies have shown promise for using Topamax to treat depression or bipolar disorder with depression, there have been no large, peer-reviewed studies that show definitively that Topamax is safe and effective for these conditions.
In one small 2002 study of 16 women with treatment-resistant depression, 44 percent treated with Topamax reported improvement after 18 weeks. Carpenter L. . Do obese depressed patients respond to topiramate? A retrospective chart review.
A more recent double-blind, placebo-controlled clinical trial was composed of 42 patients with major depressive disorder who failed to respond to at least eight weeks of treatment with a selective serotonin reuptake inhibitor such as fluoxetine, citalopram or sertraline. Mowla A, et al. . Topiramate augmentation in patients with resistant major depressive disorder: A double-blind placebo-controlled clinical trial. DOI: 10.1016/j.pnpbp.2011.01.016
The study found that the participants taking Topamax in addition to their prescribed depression medication significantly improved depressed mood, suicidality, insomnia, agitation, and anxiety symptoms compared to those taking a placebo.
This was compared to 59 percent of patients who received another common anti-depressant known as bupropion . However, like the other studies mentioned above, this study was small, including a total of 36 patients.
Rationale For Evaluating Topiramate In Psychiatric Disorders
In alcohol dependence, antiepileptic medications share neurochemical effects with alcohol by inhibiting neuronal excitation. Carbamazapine, gabapentin, and valproic acid have been reported to reduce alcohol consumption . Chronic alcohol intake is linked to decreased GABA receptor activity in the ventral tegmental area with disinhibition of dopaminergic neurons . Similarly, hippocampal and cortical GABA neurons projecting to the midbrain might facilitate dopaminergic neurotransmission in the midbrain at glutamate binding sites such as kainate/AMPA receptors . The putative efficacy of topiramate in the treatment of alcohol dependence is based on reversing chronic changes induced by alcohol resulting in dopamine-facilitated neurotransmission in the midbrain. In psychiatry, drug induced severe obesity plays an important role and substantive weight gain has been described with several psychotropic medications . Obesity is associated with an increase risk of co-morbid medical conditions such as hypertension, diabetes and cardiovascular disease . Diabetes mellitus reaches nearly 10% prevalence among hospitalized subjects with bipolar disorder in USA . Topiramate induced weigh loss in the 510% range is associated with significant reduction in blood pressure and changes in total cholesterol, low-density lipoproteins and triglycerides . There are no clear mechanisms underlying weight changes but it may be dependent of glycemic control as suggested by Chengappa et al. .
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Rated For Epilepsy Report
Bad with carbemazepine I was on this for 1 year with ~1500mg of carbemazepine . To be fair, it gave me complete control. But I was a complete zombie, being sick, getting loads of overdose symptoms from Tegretol, like moving vision and dizzyness/sickness. I was having problems eating because I always felt ‘full’. I was crying a lot, would have preferred not to be alive, and PMT went from being a few days a month to 3 weeks. I lost 2 stone in a year, with regular weeks spent with vomiting or the runs. < p> It completely wrecked my short-term memory, with inability to think properly because I couldn’t remember the train of thought. I often had a stutter, saying one word at a time, even though I never usually did – I just couldn’t find the words.< p> I’m off it now, on a milder combination, and accept the odd seizure as a fair deal for being normal the rest of the time, and having a personality.
Rated For Binge Eating Disorder Report
I was prescribed this medication for binge eating disorder, and I wanted to love it because it did what it was supposed to. I didnt binge once while I was taking it because I couldnt eat. My appetite was gone, which was great at first, but soon after that the other wonderful side effects started. I became dizzy, and of course that ended up with me vomiting everywhere. My memory wasnt really affect that much but its not stellar anyways, so take that with a grain of salt. It also causes cold like symptoms.
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Is Topamax A Controlled Substance
No, its not. Topamax is available only by prescription from your doctor, but its not a controlled substance.
Controlled substances are drugs that have certain effects that give them a high potential for being misused. They also have a high risk of leading to drug dependence. Because of these risks, there are special rules about how controlled substances are prescribed and dispensed. Topamax doesnt have a high risk of misuse or dependence.
What Is The Most Important Information I Should Know About Topamax
You should not use topiramate if you are allergic to it. Do not take Trokendi XR within 6 hours before or 6 hours after drinking alcohol.
Tell your doctor if you are sick with diarrhea, or if you have ever had:
- glaucoma or other eye problems
- metabolic acidosis
- kidney disease, kidney stones, or dialysis
- lung disease, breathing problems
- mood problems, depression, or suicidal thoughts or actions
- liver disease
- a growth disorder or
- soft or brittle bones .
Topiramate can increase the level of acid in your blood . This can weaken your bones, cause kidney stones, or cause growth problems in children or harm to an unborn baby. You may need blood tests to make sure you do not have metabolic acidosis, especially if you are pregnant.
Some people have thoughts about suicide while taking an anticonvulsant. Your doctor should check your progress at regular visits. Your family or other caregivers should also be alert to changes in your mood or symptoms.
Taking topiramate during pregnancy may increase the risk of cleft lip and/or cleft palate, a birth defect that can develop early in pregnancy even before you know you are pregnant. However, having a seizure during pregnancy could harm both the mother and the baby. Tell your doctor right away if you become pregnant.
If you are not pregnant or planning to become pregnant, use effective birth control to prevent pregnancy while taking topiramate.
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Drug Forms And Strengths
Topamax comes in two different forms:
- A tablet that you swallow. Its available in strengths of 25 milligrams , 50 mg, 100 mg, and 200 mg.
- A sprinkle capsule. The capsule can be swallowed whole or opened to sprinkle on a spoonful of soft food and swallowed. The capsule is available in strengths of 15 mg and 25 mg.
If you have trouble swallowing Topamax tablets, talk with your doctor about using Topamax sprinkle capsules instead.
What Does Phentermine And Topamax Do Together
Phentermine and topiramate is a combination medicine used together with diet and exercise to treat obesity. phentermine and topiramate is sometimes used to treat obesity that may be related to diabetes, high cholesterol, or high blood pressure. Phentermine and topiramate will not treat these underlying conditions.
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Adjunctive Therapy In Treatment
in an open-label study examined retrospectively 58 in-out patients with different psychiatric disorders, refractory to conventional mood stabilisers, and with psychiatric and medical co-morbid conditions. Forty-four patients had rapid cycling bipolar disorder , 9 had schizoaffective disorder, 3 had dementia, and 2 had psychotic illness. The range of duration of psychiatric illness was from 7 months to 40 years. The mean duration of topiramate treatment was 16.0 weeks with a mean dosage of 200 mg/day . The initial dose was 25 mg twice daily, slowly increased by 50 mg every 7 days. Response was regarded as ‘marked’ or ‘moderate’ improvement based on a Likert global assessment scale including quality of sleep, appetite, mood, and concentration during therapy. Twenty-three of the 44 rapid cycling bipolar disorder patients and 36 of the whole sample showed ‘marked’ or ‘moderate’. Six of the 13 patients with rapid cycling bipolar disorder and substance misuse showed marked or moderate improvement when topiramate was added. Adverse effects were minor and 6 patients discontinued due to adverse events . In a larger cohort continuation of open treatment with topiramate showed additional clinical improvement with longer drug exposure .
How Do You Feel On Topamax
Confusion, difficulty with concentration/attention, forgetfulness, speech or language difficulties, depression or mood problems, flushing, fever, tiredness, fatigue, weight decrease, or tingling of the extremities are common side effects. Visual field disturbances have been reported following Topamax use.
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Side Effects In Children
Topamax is approved for treating certain types of seizures in children ages 2 years and older. Its also approved for preventing migraine headaches in children ages 12 years and older.
Side effects of Topamax in children are similar to those in adults. These side effects are described above and in Side effect details below.
One clinical study looked at children ages 6 years and older who took Topamax alone for epilepsy. The most common side effects were:
- fever
- weight loss
- respiratory infections, such as colds
In other clinical studies, children ages 2 to 15 years took Topamax with other medications for epilepsy. The most common side effects in these studies were:
- fatigue
- sleepiness
- loss of appetite
In clinical studies involving children ages 12 years and older who took Topamax for migraine, the most common side effects were:
- abdomen pain
- respiratory infections, such as colds
Children who take Topamax are less likely than adults to have speech problems, slow reactions, and trouble concentrating.
Serious side effect in children
One possibly serious side effect is more common in children than in adults. Children taking Topamax are more likely than adults to have fever and reduced sweating. These problems can lead to hyperthermia , which may need treatment in a hospital.
For Females Using Topamax
Females using Topamax should use an effective method of birth control to help prevent pregnancy. However, Topamax can make birth control drugs that contain estrogen less effective at preventing pregnancy.
Examples of birth control that can be less effective when taken with Topamax include:
- levonorgestrel/ethinyl estradiol
- desogestrel/ethinyl estradiol
- drospirenone/ethinyl estradiol
- norgestimate/ethinyl estradiol
Topamax treatment can also make certain birth control medications less effective at preventing pregnancy. These include:
- the birth control patch , which is called Xulane
- the vaginal ring , which is called NuvaRing
If you use birth control that contains estrogen, your doctor may recommend switching to a different type of contraception.
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How To Use Topamax
Read the Medication Guide and, if available, the Patient Information Leaflet provided by your pharmacist before you start taking topiramate and each time you get a refill. If you have any questions, ask your doctor or pharmacist.
Take this medication by mouth with or without food as directed by your doctor, usually twice daily. Swallow the tablets whole since breaking them may leave a bitter taste. To prevent kidney stones from forming, drink plenty of liquids while taking this medication unless your doctor instructs you otherwise.
Dosage is based on your medical condition and response to treatment. For children, the dosage is also based on weight. Your doctor will gradually increase your dose to reduce your risk of side effects. For some conditions, you may start treatment with topiramate once daily at bedtime and slowly increase your dose to twice a day. It may take several weeks or months to reach the best dose for you and to get the full benefit from this medication.
Take this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day. Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Your dose may need to be gradually decreased.
Tell your doctor if your condition persists or if it worsens.
What Are The Side Effects Of Topamax
Get emergency medical help if you have signs of an allergic reaction or a severe skin reaction .
Report any new or worsening mood symptoms to your doctor, such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive , depressed, or have thoughts about suicide or hurting yourself.
- a skin rash, no matter how mild
- vision problems, blurred vision, eye pain or redness, sudden vision loss
- confusion, problems with thinking or memory, trouble concentrating, problems with speech
- dehydration symptoms–decreased sweating, high fever, hot and dry skin
- signs of a kidney stone–severe pain in your side or lower back, painful or difficult urination
- signs of too much acid in your blood–irregular heartbeats, feeling tired, loss of appetite, trouble thinking, feeling short of breath or
- signs of too much ammonia in your blood–vomiting, unexplained weakness, feeling like you might pass out.
Common side effects may include:
- dizziness, drowsiness, tired feeling, slow reactions
- problems with speech or memory
- abnormal vision
- nausea, diarrhea, stomach pain, loss of appetite
- fever, weight loss or
- cold symptoms such as stuffy nose, sneezing, sore throat.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
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