Topamax depression

Topamax and Depression: What You Need to Know

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.

A more recent double-blind, placebo-controlled clinical trial was composed of 42 patients with major depressive disorder (MDD) who failed to respond to at least eight weeks of treatment with a selective serotonin reuptake inhibitor (SSRI) such as fluoxetine, citalopram or sertraline.

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.

In another randomized, single-blind study, individuals with bipolar disorder in the depressive phase showed a significant improvement of symptoms in 56 percent of patients treated with topiramate.

This was compared to 59 percent of patients who received another common anti-depressant known as bupropion (Wellbutrin). However, like the other studies mentioned above, this study was small, including a total of 36 patients.

Larger clinical trials will be needed to confirm Topamax’s use in treating depression or bipolar depression before the drug can be approved for this condition.

Still, some doctors may choose to prescribe Topamax off label. Your doctor may decide to do this if several other antidepressant or mood-stabilizing drugs fail to control your symptoms.

Since one of the side effects of Topamax is weight loss, a doctor may also decide to prescribe Topamax alongside another antidepressant as an adjunctive therapy to help offset any weight gain that may have been caused by the antidepressant.

Can Topamax cause depression?

There have been a few reports of Topamax causing or worsening depression in people taking it for other conditions, such as seizures, migraines, or bipolar disorder.

Topamax may increase a person’s risk of experiencing suicidal thoughts or behavior (thinking about hurting or killing yourself). About 1 in every 500 people who took anticonvulsants like Topamax during clinical studies became suicidal.

symptoms to report if you take topamax
  • new depression or worsening of depression
  • suicidal thoughts
  • attempts to commit suicide
  • new or worsening anxiety
  • irritability
  • trouble sleeping
  • panic attacks
  • an extreme increase in activity and talking (mania)
  • withdrawing from friends and family
  • unusual changes in mood or behavior

What is Topamax?

Topamax is a prescription drug that belongs to a class of drugs called anticonvulsants or antiepileptic drugs (AEDs). It’s described on its FDA label as a “sulfamate-substituted monosaccharide.”

Topamax tablets come as 25 milligrams (mg), 50 mg, 100 mg, and 200 mg round tablets that are taken whole by mouth. The drug also comes in sprinkle capsules that can be broken open and sprinkled onto soft food.

The exact way that Topamax works in the body isn’t fully understood. Topamax is thought to decrease abnormal excitement in the brain. Among other actions, Topamax affects the activity of the neurotransmitter gamma-aminobutyrate (GABA).

GABA is involved in the excitability of the nervous system. Problems with the GABA system has also been thought to play a role in the development of psychiatric disorders, including anxiety and depression.

What are the side effects of Topamax?

There are many potential side effects of Topamax.

topamax side effects

These symptoms can be very serious:

If you’re pregnant, you should speak to your doctor before taking Topamax. Topamax can cause harm to the fetus. Infants exposed to Topamax in utero have an increased risk of cleft lip, cleft palate, and low weight.

What does Topamax treat? Why is it prescribed?

In 1996 the FDA approved Topamax for the treatment of partial onset or primary generalized tonic-clonic seizures and for people with seizures associated with Lennox-Gastaut syndrome.

Topiramate was also approved in 2012 for use in combination with another drug called phentermine for weight loss. This product goes by the brand name Qsymia.

In 2014, the FDA approved Topamax for the prophylaxis (prevention) of migraine in patients 12 years of age and older.

The exact way that Topamax works to help prevent migraine isn’t known. One theory is that Topamax calms overactive nerve system cells in the brain that lead to migraine attacks.

Topamax is sometimes prescribed “off label” for other conditions. Off label means the drug is used to treat a condition for which it is not approved.

Prescribing a drug off label is not illegal, though it is illegal for a drug manufacturer to market the drug specifically for the off-label use. Your doctor will assess your symptoms and history to determine if he/she thinks that using Topamax off label will help you.

conditions treated by topamax
  • seizures
  • migraine
  • obesity/weight loss
  • PTSD
  • bipolar disorder
  • eating disorders, including binge eating disorder and bulimia
  • alcohol addiction
  • cocaine addiction
  • painful nerve conditions

The bottom line

Topamax isn’t approved to treat depression or bipolar disorder with depression, but it may be helpful for people who have not found relief with other mood-stabilizing drugs. For this reason, a doctor may decide, after careful evaluation, to prescribe Topamax off label for treating depression.

On the other hand, Topamax may also cause serious depression and suicidal thoughts in some people, so it’s important that you discuss this option carefully with your doctor.

If you’re thinking about using Topamax to treat depression, you should discuss whether or not the potential benefits outweigh the risks before making a decision.

If you’re already taking Topamax and you’re feeling depressed or you’re having thoughts of suicide or self-harm, call your doctor right away. Your doctor will help you figure out if need to adjust the dose or try a new medication instead.

Sours: https://www.healthline.com/health/mental-health/topamax-depression

Topamax side effects and how to avoid them

Topamax side effects | Warnings | Interactions | How to avoid side effects

Topamax (topiramate) is a brand-name anticonvulsant drug that works in the brain to prevent seizures. It has been FDA-approved since 1996 for the treatment of epilepsy in both children and adults. Topamax is also commonly used to prevent migraine headaches in adults. It’s also used off-label to treat patients with bipolar disorder (also called manic depression) and assist with weight loss. The drug is usually prescribed in 25 mg to 400 mg doses.

Topamax is safe for long-term use when taken as prescribed. However, several common and potentially severe side effects have been reported by a small number of patients. There are also quite a few drugs that can cause harmful interactions or become ineffective when taken in conjunction with Topamax. Here’s everything you should know about safely taking Topamax, including what you can do to minimize the risk of developing severe side effects.

RELATED: What is Topamax? | Get Topamax coupons

Most of the side effects associated with Topamax are considered mild to moderate. Many will disappear or subside as you adjust to the medication. If you experience any of these symptoms, notify your doctor immediately because they might indicate more severe side effects.  These are the most common Topamax side effects, according to the manufacturer:

  • Loss of appetite, changes in taste, weight loss, stomach pain, and even anorexia
  • GI side effects (nausea, diarrhea, indigestion)
  • Tiredness
  • Paresthesia (tingling or prickling sensations)
  • Speech problems
  • Cognitive dysfunction (trouble with memory and thinking)
  • Upper respiratory tract infection
  • Dizziness
  • Nervousness
  • Slow reactions
  • Visual changes (blurred, cloudy vision, involuntary eye movements)
  • Fever
  • Decreased sensitivity or numbness

Does Topamax make you sleepy?

Taking Topamax can make you very drowsy and even dizzy. You should avoid driving, using heavy machinery, or doing other tasks that require alertness until you know how this medication affects you. Because it can cause drowsiness, Topamax is often taken at night.

Does Topamax cause brain fog?

Patients often experience brain fog, or a decrease in cognition, when beginning Topamax. Some report an inability to quickly process information, language problems, or think clearly. For some, this symptom resolves as the body acclimates to dosing. Others may need to look for Topamax alternatives.

Does Topamax make your hair fall out?

According to the National Institutes of Health, hair loss is a possible side effect of topiramate, but the manufacturer of Topamax does not list it as a common. Hair usually grows back quickly if you stop treatment. 

Serious side effects of Topamax

There are also serious side effects to be aware of when taking Topamax. These side effects usually require hospitalization or medical help, and may result in permanent injury or be life-threatening. 

  • Metabolic acidosis (tiredness, loss of appetite, irregular heartbeat, brain fog)
  • Excess ammonia in the blood (when Topamax is taken with medicine containing valproic acid)
  • New or worsening depression, anxiety, or suicidal thoughts/behaviors (occurring in 1 in 500 patients)
  • Decreased sweating but increased body temperature
  • Glaucoma
  • Stevens-Johnson syndrome (severe skin rash, blisters, peeling skin)
  • Stunted growth in children
  • Sudden withdrawal seizures (if Topamax is stopped suddenly)

Can Topamax change your personality?

Anticonvulsants like Topamax, can also profoundly affect mood, contributing to mental illnesses like anxiety, depression, or mania. Topamax can have several neurocognitive and neuropsychiatric side effects, including this case of Topamax-induced dissociative disorder. Patients should be aware of drastic changes in mood or emotion and seek medical attention if they experience significant personality changes.

Can Topamax cause permanent memory loss?

Topamax may be associated with dementia and should be used with caution in older patients. Still, it has not been well established that Topamax can cause permanent memory loss.

Topamax and metabolic acidosis

Topamax may cause an excessive amount of acid in the bloodstream, called metabolic acidosis. When this occurs, the body produces acid too quickly, and the kidneys cannot keep up with filtering it out. For this reason, patients with impaired kidney function or kidney disease should be monitored closely when taking Topamax.

In extreme cases, metabolic acidosis can lead to kidney damage, shock, or even death. This condition can also cause soft or brittle bones and kidney stones, slow the growth rate in children, and harm a baby during pregnancy. Common metabolic acidosis symptoms include rapid breathing, low blood pressure, lethargy and confusion, and loss of appetite. 

Topamax and eye problems

Topamax can cause severe eye conditions that may result in blindness. Acute myopia, which causes nearsightedness, can cause headaches or blurred vision because of increased pressure in the eye. Patients also reported several instances of secondary angle closure glaucoma, which, if left untreated, can lead to vision loss. Patients taking Topamax should seek medical advice if they ever experience eye pain or discomfort. 

Topamax warnings

Do not take Topamax if you:

  • are allergic to it or any of the ingredients in it
  • consume alcohol within 6 hours of taking Topamax
  • have or have had any of these conditions: 
    • Glaucoma or other eye problems
    • Kidney disease
    • Metabolic acidosis
    • Lung disease or breathing problems
    • Mood problems, depression, suicidal thoughts or actions
    • Growth disorders
    • Soft or brittle bones (osteoporosis, osteomalacia)
  • are planning to become pregnant or if you are breastfeeding

Suicidal behavior and ideations

As an anticonvulsant, Topamax has a direct influence on brain activity. About 1 in 500 patients taking antiepileptic drugs like Topamax have reported that they experienced suicidal thoughts and tendencies, especially when starting treatment or changing dosage levels. 

Due to these predispositions, patients should be continually monitored and seek medical attention if they experience anxiety, panic attacks, onset of or increased depression. Though rare, Topamax can also cause mood or behavior changes, like aggression or violence, agitation, apathy, mania, or irritability. Tell a healthcare professional about any of these changes.

Topamax and pregnancy

If you are pregnant or planning to become pregnant, you should inform your doctor as soon as possible. Topamax increases the risk of oral cleft birth defects like cleft lip and cleft palate by 16 times. Using Topamax during pregnancy can also cause heart, lung, skull, and skeletal abnormalities like malformed limbs. Other birth defects may include persistent pulmonary hypertension of the newborn (PPHN), spina bifida, and other neural tube defects, which can be life-threatening.

Consequently, it’s necessary to take certain precautions to decrease the risk of these potential complications by managing Topamax doses with other medications during pregnancy. Suddenly discontinuing medications like Topamax during pregnancy is not recommended, so don’t adjust your dosage or stop taking it without talking to your doctor. Topamax should only be used to treat conditions that could be life-threatening in pregnant patients.

Topamax interactions

There are many over-the-counter and prescription drugs that interact with Topamax. The side effects of those drug interactions range from mild to severe, rendering one or the other more or less effective. Ask a doctor before taking Topamax if you’re on one of the following medications:

  • Birth control pills: Topamax may reduce the potency and effects of oral contraceptives or menopause drugs containing estrogen. A barrier form of birth control like a condom or diaphragm with spermicide a better form of protection while taking Topamax.
  • Seizure drugs: Tegretol (carbamazepine), Dilantin (phenytoin), Depakote (valproate), lamotrigine, and phenobarbital may decrease the levels and effects of the Topamax in your body. Taking Depakote (valproate) in conjunction with Topamax can raise the levels of ammonia in your blood. If this occurs, you may experience confusion, disorientation, or have difficulty thinking.  
  • Carbonic anhydrase inhibitors: Drugs like acetazolamide, dichlorphenamide, methazolamide, and dorzolamide can increase the risk of kidney stones when they are taken with Topamax.
  • Allergy medicine: Certain allergy drugs like diphenhydramine, chlorpheniramine, hydroxyzine may increase the risk of side effects like dizziness, sleepiness, or trouble concentrating.
  • Pain relievers: Patients taking Topamax may experience increased drowsiness, dizziness, or trouble thinking when prescribed in conjunction with pain drugs like hydrocodone, oxycodone, morphine, or hydromorphone.  
  • Bipolar medication: Topamax may increase levels of lithium in the body when taken together.
  • Diabetes drugs: Glyburide or pioglitazone may be less effective in controlling blood sugar to treat diabetes. Taking metformin with Topamax can also be risky, especially if the patient has metabolic acidosis. 

Can you drink caffeine with Topamax?

Topamax can increase caffeine’s excretion rate, which may reduce its efficacy in the body, but it’s generally a safe combination.

What should I eat while taking Topamax?

You can take Topamax with or without food. Since one of the most severe side effects of taking Topamax is metabolic acidosis, avoid eating a ketogenic (low carbohydrate, increased protein) diet. Eating foods that promote ketosis may increase the risk of kidney stones, which can further tax your kidneys.

For more drug information, read the Topamax medication guide before starting your treatment.

  1. If you experience any side effects, consult your healthcare provider. Consistent serum tests to routinely check kidney and liver function, for example, can also reduce the risk of severe complications. 
  2. Be aware of all drug interactions. Some drugs like oral contraceptives aren’t as effective when taken with Topamax, and others, like allergy medicine, can exacerbate Topamax side effects.
  3. Don’t take Topamax within six hours of consuming alcohol. 
  4. Avoid operating heavy machinery, driving, or performing other dangerous tasks if Topamax makes you drowsy or dizzy. 
  5. Drink lots of fluids and make an effort to avoid dehydration and constipation. This can help to reduce the risk of kidney stone formation, which can help prevent metabolic acidosis. 
  6. Avoid following a ketogenic diet to prevent kidney stone development and potential metabolic acidosis. 
  7. Seek urgent medical attention if you notice any sudden changes in mood or the development of depression or suicidal thoughts. 
  8. If you are a woman on oral contraceptives, consider using an additional barrier form of protection to prevent pregnancy. That is one of the most effective ways to avoid the risk of severe birth defects associated with taking Topamax.
  9. If you miss a dose, take it as soon as you remember. If it’s almost time for your next dose, skip it and take the upcoming dose. Don’t take a double amount to make up for a missed dose.
  10. Don’t stop taking Topamax suddenly, as that may cause seizures, even if you haven’t had them in the past. If you need to stop taking Topamax, your doctor will gradually decrease your dose to safely wean you off the medication.

When to see a doctor for Topamax side effects

Many Topamax side effects can be severe and life-threatening. Inform your healthcare professional and seek medical attention right away if you begin to experience any of them, especially those considered serious.

Sours: https://www.singlecare.com/blog/topamax-side-effects/
  1. Sullivans steakhouse
  2. Vti morningstar
  3. Samsung account
  4. Dewalt liion

Is Topiramate a Mood Stabilizer?

A few readers may remember an open trial (no control group) of topiramate for PTSD, when the drug was new, in which dramatic improvements were seen.6 That study appears to have been one of many in which early open trials suggest benefit not later confirmed in randomized trials. (Thus the cynical aphorism: “when a new drug comes out, use it quick before it stops working.”)

Subsequent meta-analyses have not found topiramate to be better than placebo for PTSD.7 Granted, some patients’ responses to topiramate, for PTSD or mood or anxiety, may be excellent (one study was quite positive, for example.8) Let not my review lead to a deflation of their belief or response. At the same time, the most recent meta-analysis confirms again that treatments with the largest effect sizes in PTSD are psychotherapies. Sertraline outperformed other antidepressants in this setting except for the potential hypertension-and-hypomania inducer, venlafaxine.7

Nevertheless, as an antidote for antipsychotic-induced weight gain, topiramate is effective. In that context, the average weight loss in randomized trials was 2.8 kg (not as much as the 3.8 kg average in patients who did not take antipsychotics, but still negative!).9 And for binge eating, the evidence shows clear benefit.10

Just be careful to warn patients about those cognitive effects, as well as renal stones. One of my patients, a high-powered executive, told me that she nearly lost a multi-million-dollar contract when she was pitching it after recently starting topiramate. Colleagues recognized her impairment, gently moved her aside, and won the deal. And don’t expect it to add to mood stability -unless, as I sometimes do, one proceeds in the desperate hope that effective weight loss might improve things (one trial in depression showed some value11).

This article was originally posted on 10/11/2016 and has since been updated.

Disclosures:

Dr Phelps is Director of the Mood Disorders Program at Samaritan Mental Health in Corvallis, Ore. He is the Bipolar Disorder Section Editor for Psychiatric Times. Dr Phelps stopped accepting honoraria from pharmaceutical companies in 2008 but receives honoraria from McGraw-Hill and W.W. Norton & Co. for his books on bipolar disorders.

References:

1. Phelps JR, Siemers SV, El-Mallakh RS. The ketogenic diet for type II bipolar disorder. Neurocase. 2013;19:423-426.
2. Pande AC, Crockatt JG, Janney CA, et al. Gabapentin in bipolar disorder: a placebo-controlled trial of adjunctive therapy. Gabapentin Bipolar Disorder Study Group. Bipolar Disord. 2000;2(3 pt 2):249-255.
3. Domecq JP, Prutsky G, Leppin A, et al. Clinical review: drugs commonly associated with weight change: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2015;100:363-370.
4. Lee S, Sziklas V, Andermann F, et al. The effects of adjunctive topiramate on cognitive function in patients with epilepsy. Epilepsia. 2003;44:339-347.
5. Pigott K, Galizia I, Vasudev K, et al. Topiramate for acute affective episodes in bipolar disorder in adults.Cochrane Database Syst Rev. 2016;9:CD003384.
6. Berlant J, van Kammen DP. Open-label topiramate as primary or adjunctive therapy in chronic civilian posttraumatic stress disorder: a preliminary report. J Clin Psychiatry. 2002;63:15-20.
7. Lee DJ, Schnitzlein CW, Wolf JP, et al. Psychotherapy versus pharmacotherapy for posttraumatic stress disorder: systemic review and meta-analyses to determine first-line treatments. Depress Anxiety. 2016;33:792-806.
8. Yeh MS, Mari JJ, Costa MC, et al. A double-blind randomized controlled trial to study the efficacy of topiramate in a civilian sample of PTSD. CNS Neurosci Ther. 2011;17:305-310.
9. Mahmood S, Booker I, Huang J, Coleman CI. Effect of topiramate on weight gain in patients receiving atypical antipsychotic agents. J Clin Psychopharmacol. 2013;33:90-94.
10. Brownley KA, Berkman ND, Peat CM, et al. Binge-eating disorder in adults: a systematic review and meta-analysis. Ann Intern Med. 2016;165:409-420.
11. Mowla A, Kardeh E. Topiramate augmentation in patients with resistant major depressive disorder: a double-blind placebo-controlled clinical trial. Prog Neuropsychopharmacol Biol Psychiatry. 2011;35:970-973.

Sours: https://www.psychiatrictimes.com/view/topiramate-mood-stabilizer

Warning:The primary use of Topiramate, and the only use for which it has regulatory approval, is to treat seizures. Some people use Topiramate to treat other conditions, which may include PTSD, Axis II mood disorders, and eating disorders. However, no peer-reviewed studies have established that Topiramate is safe and effective for those conditions, and therefore these uses have not been approved by the FDA. There is limited evidence supporting these uses that comes from small-scale case studies, but as yet there have been no large studies that researchers have published.


What is Topiramate?

Topiramate is often sold under the brand name Topamax. It is an anti-convulsive drug that stands apart from all other drugs used to treat convulsions or mood disorders because it does not share the same chemical composition. Medical researchers currently do not know how Topiramate works.


When did the FDA approve this drug for marketing in the US, and what uses of the drug are approved?

The FDA gave final approval for the drug on December 24, 1996. As stated above, the only approved use to date is the treatment of convulsions.


Does Topiramate have a generic version?

The manufacturer of Topiramate still holds patent protection over the drug, so there is no generic version available yet.


How is Topiramate different from other mood stabilizers?

There are two things that set Topiramate apart from other drugs in this class. First of all, physicians and psychiatrists sometimes prescribe it when other mood-stabilizing drugs fail to be effective for a patient. Secondly, the set of side effects that patients may experience is quite different on Topiramate compared to other mood stabilizers.


How is Topiramate different from carbamazepine and valproate?

For rapid cycling or mixed bipolar states, there are some cases where Topiramate is effective when these other two drugs are not.


Which disorders has Topiramate been most successful in controlling so far?

The lack of research about Topiramate makes it hard to tell which disorders will respond best to the drug: to date, there is not enough psychiatric research to make specific recommendations. In the field, practitioners have had success when prescribing Topiramate to individuals with bipolar disorders that have resisted other forms of treatment. The most effective use of Topiramate appears to be the case of patients whose use of lamotrigine has induced mania. Some psychiatrists have reported using Topiramate to help relieve the symptoms of PTSD and the side effects related to eating that other psychiatric drugs can create.


Can Topiramate treat episodes of depression, mania, and mixed states? Can it prevent these episodes?

While Topiramate’s first use was for the treatment of mania, depression, or mixed states that were resistant to other drugs, its effectiveness for preventing those states has not yet been tested. There have been no research studies that placed patients on Topiramate for an extended time and evaluated whether it decreased their likelihood of these episodes.


What lab tests are necessary before a patient can be prescribed Topiramate?

It is important to test for any of several conditions that can interact with mood disorders. The necessary tests include blood and urine tests, because these conditions could be the cause of a mood disorder.


What dosage is appropriate for starting a course of Topiramate?

The initial dose for Topiramate should be either 12.5 or 25 milligrams taken either once or twice a day. This dose increases by 12.5 or 12 milligrams each week until it reaches the final level, which depends on the use of the drug and how the patient is responding. A typical final dosage is between 100 and 200 mg per day, although some patients benefit from no more than 50 mg. The case of PTSD entails a final dose of approximately 175 mg per day and generally not exceeding 500 mg per day.


Are there any special problems prescribing Topiramate for
people taking lithium, carbamazepine (Tegretol), or valproate (Depakene, Depakote)?

There are no known interactions between Topiramate and lithium. However, carbamazepine can lower the blood-plasma level of Topiramate by 50 percent and valproate can lower it by 15 percent. Topiramate itself can lower the blood-plasma level of valproate by 10 percent. Thus far, there are no known interactions for patients taking Topiramate and either lamotrigine or gabapentin.


What final doses of Topiramate are typical and what doses are appropriate for different disorders?

The final doses of Topiramate vary widely based on the targeted disorder, the patient, and whether or not the patient is taking any other drugs at the same time. The most common doses fall between 50 and 200 mg a day for most therapies, but this can be lower for PTSD. Higher final doses may be required if Topiramate is being taken alone, up to 500 mg a day. Some patients experience relief with only 25 mg a day.


How long until the patient feels the effects of Topiramate?

This also varies significantly depending on the individual. Some feel the effects within days, while others need up to a month before they feel any difference.


What is the side effect profile of Topiramate?

Topiramate’s side effects appear most strongly just after an increase in dosage. A research study that compared 711 participants taking Topiramate and 419 taking a placebo observed the following sets of side effects in both groups:
Common Adverse Reactions (%)

(Topiramate = 200 mg/day)
Adverse Reaction Topiramate Placebo

Somnolence 30% versus 10% Placebo

Dizziness 28% versus 14% Placebo

Vision problems 28% versus 9% Placebo

Unsteadiness 21% versus 7% Placebo

Speech problems 17% versus 3% Placebo

Psychomotor slowing 17% versus 2% Placebo

Pins and needles 15% versus 3% Placebo

Nervousness 16% versus 8% Placebo

Nausea 12% versus 6% Placebo

Memory problems 12% versus 3% Placebo

Tremor 11% versus 6% Placebo

Confusion 10% versus 6% Placebo


Which of these side effects are the strongest?

The five side effects that were most likely to cause people to discontinue use of Topiramate were psychomotor slowing, fatigue, memory problems, confusion, and somnolence. In rare cases, approximately one person of patients develop kidney stones and a very few develop acute glaucoma.


What psychiatric side effects do people who take Topiramate experience?

The list includes sedation, psychomotor slowing, agitation, anxiety, concentration problems, forgetfulness, confusion, depression, and depersonalization. There are also rare cases of psychosis.


How does Topiramate interact with prescription and
over-the-counter medications?

The interactions between Topiramate, valproate, and carbamazepine have already been noted above. In addition to that, Topiramate appears to raise the blood-plasma level of phenytoin, while phenytoin decreases the level of Topiramate by 50 percent. There have been some reports that Topiramate reduces the effectiveness of oral contraceptive pills.


Is it safe to take Topiramate and drink alcohol?

If you drink while taking Topiramate, then you may experience more intense side effects.


Is it safe to take Topiramate if you are pregnant?

The FDA places Topiramate in the “C” category for pregnancy safety. That means the drug is known to affect the human fetus in an adverse way, but there is not much research about the specifics, and that the drugs benefits may outweigh the risks.


Is it safe for children and teens to take Topiramate?

Yes, the FDA has approved the drug for children.


Is it safe for older adults to take Topiramate?

So far, there are no reports about using Topiramate for older adults, although there is no reason to believe that they would have a different response to it.


Is it necessary to wean off Topiramate?

There are no reports of bad reactions to suddenly stopping use of Topiramate, so there is no need to wean off the drug. On the other hand, the entire class of anticonvulsants is known to lead to seizures if you stop taking them suddenly. Therefore, the only thing that should lead to a sudden cessation of Topiramate use is the rise of a dangerous side-effect.


Is it possible to overdose on Topiramate?

There are no reported effects and no deaths from an overdose of Topiramate.


Does Topiramate interact poorly with MAOIs?

There is no danger in taking Topiramate with MAOIs.


Is Topiramate expensive?

When bought in bulk, Topiramate is not particularly expensive. The 25 mg per pill set costs about $1.45 a pill, 100 mg costs $3.75 a pill, and 200 mg costs about $5.75 a pill.


Can Topiramate help people who have not found relief with other psychopharmacologics?

That is precisely the role of Topiramate. It is effective for those who found no useful effect from other mood stabilizers. Potential new uses of the drug include PTSD and reducing alcohol cravings, as well as heading off migraine headaches.


Why use Topiramate?

Topiramate is most useful for people who have bipolar mood disorders that other mood stabilizers have been unable to control. It can relieve symptoms and make taking antidepressants possible for people who ere unable to take them before without experiencing mania or a mixed state. Topiramate has a favorable side effect profile and up to half of all people who take the drug experience weight loss. This is a beneficial counteraction to the weight gain that many antidepressants can cause.


Does Topiramate have downsides?

Because the drug is only about 20 years old, there has not been much study about prolonged use, especially with regards to side effects. There has not been enough time to determine how long the benefits of Topiramate last and if they end or reduce after sufficient time. Likewise, much of the drug’s use as a mood stabilizer and for disorders like PTSD is currently not supported by a large body of research, pending more publications.


If Topiramate has so little evidence supporting its use, why should anyone prescribe it over an older drug that has more research showing its effectiveness?

First of all, Topiramate generally has a better side effect profile than those older drugs. Some patients find that older mood stabilizers have side effects that are too dangerous or impact their lives too much.
Second of all, many patients find that the older drugs do not control their disorders, while Topiramate does. That makes it the only effective known remedy for them.
Lastly, topirmate is so far the only psychopharmacologic agent that appears to have an effect in providing relief for PTSD symptoms. These symptoms can be extremely debilitating.


Is Topiramate prescribed all over the world?

Yes, many nations have approved Topiramate for use and prescribe it.

Last Updated: Nov 18, 2018

Sours: https://www.psycom.net/depression.central.topiramate.html

Depression topamax

Review of the use of Topiramate for treatment of psychiatric disorders

References

  • Maryanoff BE, Nortey SO, Gardoki JF, Shank RP, Dodgson SP. Anticonvulsant O-alkyl sulpamates. 2, 3 4, 5-bis-O-(1-methylethylidene)-B-D-fructopyranose sulfamate and related compounds. J Med Chem. 1987;30:880–887. [PubMed] [Google Scholar]
  • Schneiderman JH. Topiramate: pharmacokinetics and pharmacodynamics. Can J Neurol Sci. 1998;25:S3–5. [PubMed] [Google Scholar]
  • Doose DR, Walker SA, Gisclon LG, Nayak RK. Single dose pharmacokinetics and effect of food on the bioavailability of Topiramate, a novel antiepileptic drug. Journal of Clinical Pharmacology. 1996;36:884–891. [PubMed] [Google Scholar]
  • Rosenfeld WE. Topiramate: a review of preclinical, pharmacokinetic, and clinical data. Clin Ther. 1997;19:1294–308. doi: 10.1016/S0149-2918(97)80006-9. [PubMed] [CrossRef] [Google Scholar]
  • Sachdeo RC, Sachdeo SK, Walker SA, Kramer LD, Nayak RK, Doose DR. Steady state pharmacokinetics of Topiramate and carbamazepine in patients with epilepsy during monotherapy and concomitant therapy. Epilepsia. 1996;37:774–780. [PubMed] [Google Scholar]
  • Raritan NJ. Topamax package insert. Ortho-McNeil Pharmaceutical. 2000.
  • Wauquier A, Zhou S. Topiramate: a potent anticonvulsant in the amygdale-kindled rat. Epilepsy Research. 1996;24:73–77. doi: 10.1016/0920-1211(95)00105-0. [PubMed] [CrossRef] [Google Scholar]
  • Kuzniecky R, Hetherington H, Ho S, Pan J, Martin R, Gilliam F, Hugg J, Faught E. Topiramate increases cerebral GABA in healthy humans. Neurology. 1998;51:627–629. [PubMed] [Google Scholar]
  • Gordey M, DeLorey TM, Olsen RW. Differential sensitivity of recombinant GABA (A) receptors expressed in Xenopus oocytes to modulation by Topiramate. Epilepsia. 2000;41:S25–S29. [PubMed] [Google Scholar]
  • White HS, Brown SD, Woodhead JH, Skeen GA, Wolf HH. Topiramate modulates GABA – evoked currents in murine cortical neurons by non-benzodiazepine mechanism. Epilepsia. 2000;41:S17–S20. [PubMed] [Google Scholar]
  • Gibbs JW, 3rd, Sombati S, DeLorenzo RJ, Coulter DA. Cellular actions of Topiramate: blockade of kainite-evoked inward currents in cultured hippocampal neurons. Epilepsia. 2002;41:S10–S16. [PubMed] [Google Scholar]
  • Coulter DA, Sombati S, DeLorenzo RJ. Selective effects of topiramate on sustained and repetitive firing and spontaneous bursting in cultured hippocampal neurons (Abstract) Epilepsia. 1993;34:123. [PubMed] [Google Scholar]
  • Dodgson SJ, Shank RP, Marynoff BE. Topiramate as an inhibitor of carbonic anhydrase isoenzymes. Epilepsia. 2000;41:S35–S39. [PubMed] [Google Scholar]
  • Takezaki H, Hanaoka M. The use of carbamazapine (Tegretol) in the control of manic-depressive psychoses and other manic, depressive states. Clin Psychiatry. 1971;13:173–182.[Google Scholar]
  • Post RM, Uhde TW. Treatment of mood disorders with antiepileptic medications: clinical and theoretical implications. Epilepsia. 1983;24:S97–S108. [PubMed] [Google Scholar]
  • Post RM, Frye MA, George MS, Callahan AM. The place of anticonvulsant therapy in bipolar illness. Psychopharmacology. 1996;128:115–129. doi: 10.1007/s002130050117. [PubMed] [CrossRef] [Google Scholar]
  • Lishman WA. Epilepsy. In: Lishman WA, editor. Organic Psychiatry. London, UK: Blackwell Scientific Publications; 1978. pp. 346–362. [Google Scholar]
  • Solomon DA, Miller IW, Ryan CE, Keitner GI. Polypharmacy in Bipolar I Disorder. Psychopharmacol Bull. 1996;32:579–587. [PubMed] [Google Scholar]
  • Bowden CL, Calabrese JR, McElroy SL, Gyulai L, Wassef A, Petty F, Pope HG, Jr, Chou JC, Keck PE, Jr, Rhodes LJ, Swann AC, Hirschfeld RM, Wozniak PJ. A randomised placebo-controlled 12 months trial of divalproex and lithium in treatment of outpatients with bipolar I disorder. Divalproex Maintenance Study Group. Arch Gen Psychiatry. 2000;57:481–9. doi: 10.1001/archpsyc.57.5.481. [PubMed] [CrossRef] [Google Scholar]
  • Chengappa RKN, Gershon S, Levine J. The evolving role of topiramate among other mood stabilizers in the management of bipolar disorder. Bipolar Disorders. 2001;3:215–232. [PubMed] [Google Scholar]
  • Thase ME, Sachs GS. Bipolar depression, pharmacotherapy and related therapeutic strategies. Biol Psychiatry. 2000;48:558–572. doi: 10.1016/S0006-3223(00)00980-X. [PubMed] [CrossRef] [Google Scholar]
  • Dunn RT, Frye MS, Kimbrell TA, Denicoff KD, Leverich GS, Post RM. The efficacy and use of anticonvulsants in mood disorders. Clin Neuropharmacol. 1998;21:215–35. [PubMed] [Google Scholar]
  • Calabrese JR, Fatemi SH, Kujawa M, Woyshville MJ. Lithium and the anticonvulsants in the treatment of bipolar disorder. In: Bloom FE, Kupfer DJ, editor. Psychopharmacology: The Fourth Generation of Progress. New York: Raven Press; 1995. [Google Scholar]
  • Dubovsky SL, Buzan RD. Novel alternatives and supplements to lithium and anticonvulsants for Bipolar Affective Disorder. J Clin Psychiatry. 1997;58:224–242. [PubMed] [Google Scholar]
  • Prien RF, Gelenberg AJ. Alternatives to lithium for preventative treatment of Bipolar Disorder. Am J Psychiatry. 1989;146:840–848. [PubMed] [Google Scholar]
  • Maj M, Priozzi R, Kemali D. Long-term outcome of lithium prophylaxis in patients initially classified as complete responders. Neuropsychopharmacology. 1989;98:535–538. doi: 10.1007/BF00441955. [PubMed] [CrossRef] [Google Scholar]
  • Ghaemi S, Goodwin F. Use of atypical antipsychotic agents in bipolar and schizoaffective disorders: Review of the empirical literature. J Clin Psychopharmacol. 1999;19:354–361. doi: 10.1097/00004714-199908000-00012. [PubMed] [CrossRef] [Google Scholar]
  • Altshuler LL, Post RM, Leverich GS, Mikalauskas K, Rosoff A, Ackerman L. Antidepressant-induced mania and cycle acceleration: a controversy revisited. Am J Psychiatry. 1995;152:1130–1138. [PubMed] [Google Scholar]
  • Stoll AL, Mayer PV, Kolbrener M, Goldstein E, Suplit B, Lucier J, Cohen BM, Tohen M. Antidepressant associated mania: a controlled comparison with spontaneous mania. Am J Psychiatry. 1994;151:1642–1645. [PubMed] [Google Scholar]
  • Sporn J, Sachs G. The anticonvulsant lamotrigine in treatment-rasistant manic-depressive illness. J Clin Psychopharmacol. 1997;17:185–189. doi: 10.1097/00004714-199706000-00008. [PubMed] [CrossRef] [Google Scholar]
  • Calabrese JR, Suppes T, Bowden CL, Sachs GS, Ascher JA, Monaghan E, Rudd GD. A double blind placebo controlled study of lamotrigine monotherapy in outpatients with bipolar I depression. Lamictal 602 Study Group. J Clin Psychiatry. 1999;60:79–88. [PubMed] [Google Scholar]
  • Calabrese JR, Suppes T, Bowden CL, Sachs GS, Ascher JA, Monaghan E, Rudd GD. A double blind placebo controlled prophylaxis study of lamotrigine in rapid cycling bipolar disorder. Lamictal 614 Study Group. J Clin Psychiatry. 2000;157:124–126. [PubMed] [Google Scholar]
  • Cowen PJ. Treatments for resistant depression. In: Checkley, editor. The management of Depression. London: Blackwell; 1998. pp. 234–251. [Google Scholar]
  • Carlsson A, Hansson LO, Carlsson ML. A glutamatergic deficiency model of schizophrenia. Br J Psychiatry. 1999;174:2–6. [PubMed] [Google Scholar]
  • Coyle JT. The glutamatergic dysfunction hypothesis of schizophrenia. Harvard Rev Psychiatry. 1996;3:241–53. [PubMed] [Google Scholar]
  • Deutsch SI, Rosse RB, Schwartz BL, Mastropaolo J. A revisited excitotoxic hypothesis of schizophrenia: therapeutic implications. Clin Neuropharmacol. 2001;24:43–49. doi: 10.1097/00002826-200101000-00008. [PubMed] [CrossRef] [Google Scholar]
  • Tamminga CA. Schizophrenia and glutamatergic transmission. Crit Rev Neurobiol. 1998;12:21–36. [PubMed] [Google Scholar]
  • Farber NB, Newcomer JW, Olney JW. The glutamate synapse in neuropsychiatric disorders. Prog Brain Res. 1998;116:421–37. [PubMed] [Google Scholar]
  • Berlant JL, Van Kammen DP. Open label topiramate as primary or adjunctive therapy in chronic civilian posttraumatic stress disorder: a preliminary report. J Clin Psychiatry. 2002;63:15–20. [PubMed] [Google Scholar]
  • Post RM, Weiss SR, Smith M, Li H, McCann U. Kindling versus quenching: implications for the evolution and treatment of posttraumatic stress disorder. Ann NY Acad Sci. 1997;821:285–295. [PubMed] [Google Scholar]
  • Clark RD, Canive JM, Calais LA, Qualls CR, Tuason VB. Divalproex in posttraumatic stress disorder: an open label clinical trial. J Trauma Stress. 1999;12:395–401. doi: 10.1023/A:1024797014210. [PubMed] [CrossRef] [Google Scholar]
  • Ford N. The use of anticonvulsant in posttraumatic stress disorder: case study and overview. J Trauma Stress. 1996;9:857–863. [PubMed] [Google Scholar]
  • Keck PE, Jr, McElroy SL, Friedman LM. Valproate and carbamazapine in the treatment of panic and posttraumatic stress disorders, withdrawal states and behavioural dyscontrol syndromes. J Clin Psychopharmacol. 1992;12:36S–41S. [PubMed] [Google Scholar]
  • Hertzberg MA, Butterfield MI, Feldman ME, Beckham JC, Sutherland SM, Connor KM, Davidson JR. A preliminary study of lamotrigine for the treatment of posttraumatic stress disorder. Biol Psychiatry. 1999;45:1226–1229. doi: 10.1016/S0006-3223(99)00011-6. [PubMed] [CrossRef] [Google Scholar]
  • Privitera MD. Topiramate: a new antiepileptic drug. Ann Pharmacother. 1997;31:1164–1173. [PubMed] [Google Scholar]
  • Stanley BG, Ha LH, Spears LC, Dee MG., 2nd Lateral hypothalamic injections of glutamate, kainic acid, D, L-alpha-amino-3-hydroxy-5methyl-isoxazole propionic acid or N-methyl-D-aspartic acid rapidly elicit intense transient eating in rats. Brain Res. 1993;613:88–95. doi: 10.1016/0006-8993(93)90458-Y. [PubMed] [CrossRef] [Google Scholar]
  • Stanley BG, Willett VL, 3rd, Donias HW, Ha LH, Spears LC. The lateral hypothalamus: a primary site mediating excitatory amino acid-elicited eating. Brain Res. 1993;630:41–49. doi: 10.1016/0006-8993(93)90640-9. [PubMed] [CrossRef] [Google Scholar]
  • de Zwaan M, Mitchell JE, Raymond NC, Spitzer RL. Binge eating disorder: clinical features and treatment of a new diagnosis. Harv Rev Psychiatry. 1994:310–325. [PubMed] [Google Scholar]
  • York DA, Singer L, Thomas S, Bray GA. Effect of topiramate on body weight and body composition of Osborne-Mendel rats bed a high fat diet: alteration in hormones, neuropeptides, and uncoupling protein in mRNAs. Nutrition. 2000;16:967–75. doi: 10.1016/S0899-9007(00)00451-2. [PubMed] [CrossRef] [Google Scholar]
  • Hudson JI, Pope HG. The role of anticonvulsants in the treatment of bulimia. In: McElroy SL, Pope HG, editor. Use of anticonvulsants in Psychiatry: Recent Advances. Clifton, NJ: Oxford Health Care; 1988. pp. 141–154. [Google Scholar]
  • Laederach-Hofmann K, Graf C, Horber F, Lippuner K, Lederer S, Michel R, Schneiderr M. Imipramine and diet counseling with psychological support in the treatment of obese binge eaters: a randomized, placebo-controlled double blind study. Int J Eat Disord. 1999;26:231–244. doi: 10.1002/(SICI)1098-108X(199911)26:3<231::AID-EAT1>3.0.CO;2-6. [PubMed] [CrossRef] [Google Scholar]
  • McCann UD, Agras WS. Successful treatment of non-purging bulimia nervosa with desipramine: a double blind placebo controlled study. Am J Psychiatry. 1990;147:1509–13. [PubMed] [Google Scholar]
  • Stunkard A, Berkowitz R, Tanrikut C, Reiss E, Young L. D-Fenfluramine treatment of binge eating disorder. Am J Psychiatry. 1996;153:1455–59. [PubMed] [Google Scholar]
  • Fluoxetine Bulimia nervosa study Group Fluoxetine in the treatment of bulimia nervosa: a multi center, placebo controlled, double blind trial. Arch Gen Psychiatry. 1992;49:139–147. [PubMed] [Google Scholar]
  • Kaplan AS, Garfinkel PE, Darby PL, Garner DM. Carbamazapine in the treatment of bulimia. Am J Psychiatry. 1983;140:1225–1226. [PubMed] [Google Scholar]
  • Wermuth BM, Davis KL, Hollister LE, Stunkard AJ. Phenytoin treatment of binge eating syndrome. Am J Psychiatry. 1977;134:1249–1253. [PubMed] [Google Scholar]
  • Green RS, Rau JH. Treatment of compulsive eating disturbances with anti-convulsivant medication. Am J Psychiatry. 1974;131:428–432. [PubMed] [Google Scholar]
  • Malcolm R, Myrick H, Brady KT, Ballenger JC. Update on anticonvulsants for the treatment of alcohol withdrawal. Am J Addict. 2001;9:16–23. doi: 10.1080/10550490150504100. [PubMed] [CrossRef] [Google Scholar]
  • Kohl RR, Katner JS, Chernet E, McBride WJ. Ethanol and negative feedback regulation of mesolimbic dopamine release in rats. Psychopharmacology. 1998;139:79–85. doi: 10.1007/s002130050692. [PubMed] [CrossRef] [Google Scholar]
  • Dodd PR, Beckmann AM, Davidson MS, Wilce PA. Glutamate-mediated transmission, alcohol, and alcoholism. Neurochem Int. 2000;37:509–533. doi: 10.1016/S0197-0186(00)00061-9. [PubMed] [CrossRef] [Google Scholar]
  • Breese CR, Freedman R, Leonard SS. Glutamate receptor subtype expression in the human post-mortem brain tissue from schizophrenic and alcohol abusers. Brain Res. 1995;674:82–90. doi: 10.1016/0006-8993(94)01384-T. [PubMed] [CrossRef] [Google Scholar]
  • Baptista T, Lacruz A, De Mendoza D, Mendoza JM, Silvera R, Angeles F, Mendoza MT, Hernandez L. Body weight gain after administration of antipsychotic drugs. Pharmacopsychiatry. 2002;35:36. doi: 10.1055/s-2002-19839. [PubMed] [CrossRef] [Google Scholar]
  • Elmslie JL, Silverstone JT, Mann JI, Williams SM, Romans SE. Prevalence of overweight and obesity in bipolar patients. J Clin Psychiatry. 2000;61:179–184. [PubMed] [Google Scholar]
  • Allison DB, Mentore JL, Heo M, Chandler LP, Cappelleri JC, Infante MC, Weiden PJ. Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatry. 1999;156:1686–1696. [PubMed] [Google Scholar]
  • Sachs GS, Guille C. Weight gain associated with use of psychotropic medications. J Clin Psychiatry. 1999;60:16–9. [PubMed] [Google Scholar]
  • Willet WC, Diez WH, Colditz GA. Guidelines for healthy weight. N Engl J Med. 1999;341:427–34. doi: 10.1056/NEJM199908053410607. [PubMed] [CrossRef] [Google Scholar]
  • Cassidy F, Ahearn E, Carroll BJ. Elevated frequency of diabetes mellitus in hospitalized manic depressive patients. Am J Psychiatry. 1999;156:1417–20. [PubMed] [Google Scholar]
  • Bray GA, Hollander P, Klein S, Kushner R, Levy B, Fitchet M, Perry BH. A 6-Month Randomized, Placebo-Controlled, Dose-Ranging Trial of Topiramate for Weight Loss in Obesity. Obesity Research. 2003;11:722–733. [PubMed] [Google Scholar]
  • Chengappa RKN, Levine J, Rathore D, Parepally H, Atzert R. Long term effects of topiramate on bipolar mood instability, weight change and glycemic control: a case-series. Eur Psychiatry. 2001;16:186–90. doi: 10.1016/S0924-9338(01)00562-4. [PubMed] [CrossRef] [Google Scholar]
  • Calabrese JR, Keck PE, Jr, McElroy SL, Shelton MD. A pilot study of topiramate as monotherapy in the treatment of acute mania. J Clin Psychopharmacol. 2001;21:340–342. doi: 10.1097/00004714-200106000-00015. [PubMed] [CrossRef] [Google Scholar]
  • Grunze HC, Normann C, Langosch J, Schaefer M, Amann B, Sterr A, Schloesser S, Kleindienst N, Walden J. Antimanic efficacy of topiramate in 11 patients in an open trial with an on-off design. J Clin Psychiatry. 2001;62:464–8. [PubMed] [Google Scholar]
  • Bozikas VP, Petrikis P, Kourtis A, Youlis P, Karavatos A. Treatment of acute mania with topiramate in hospitalized patients. Progress in Neuro-Psychopharmacology & Biological Psychiatry. 2002;26:1203–06. doi: 10.1016/S0278-5846(01)00323-2. [PubMed] [CrossRef] [Google Scholar]
  • Calabrese JR. A placebo-controlled study of topiramate in acute mania. Munich: European College of Neuropsychopharmacology annual meeting. 2000.
  • Keck PE, Jr, DelBello MP. Advances in pharmacologic treatment-Bipolar mania. Current Psychiatry. 2002.
  • Kusumakar V, Lakshmi N, Yatham MB, O'Donovan CA, Kutcher SP. 152nd Annual Meeting of the American Psychiatric Association. Washington, DC; 1999. Topiramate in rapid cycling bipolar women. [Google Scholar]
  • Marcotte D. Use of Topiramate, a new anti-epileptic as a mood stabiliser. J Affective Disorder. 1998;50:245–251. doi: 10.1016/S0165-0327(98)00110-4. [PubMed] [CrossRef] [Google Scholar]
  • Marcotte D. Longer term treatment with topiramate for bipolar disorders. Bipolar Disord. 2001;3:46.[Google Scholar]
  • Chengappa RKN, Rathore D, Levine J, Atzert R, Solai L, Parepally H, Levin H, Moffa N, Delaney J, Brar JS. Topiramate as add-on treatment for patients with bipolar mania. Bipolar Disord. 1999;1:42–53. doi: 10.1034/j.1399-5618.1999.10111.x. [PubMed] [CrossRef] [Google Scholar]
  • McElroy SL, Suppes T, Keck PE, Frye MA, Denicoff KD, Altshuler LL, Brown ES, Nolen WA, Kupka RW, Rochussen J, Leverich GS, Post RM. Open label adjunctive Topiramate in the treatment of bipolar disorders. Biol Psychiatry. 2000;47:1025–33. doi: 10.1016/S0006-3223(99)00316-9. [PubMed] [CrossRef] [Google Scholar]
  • Sachs G, Koslow GC, Orsini C, Cosgrove V, Sambur M, Demopulos C, Ghaemi S. Topiramate shows efficacy in the treatment of refractory bipolar mood disorder. 22nd Congress of the Collegium of Internationale Psychopharmacologieum. Brussels, Belgium. 2000.
  • Eads LA, Kramer T. Effects of topiramate on global functioning in treatment-refractory mood disorders: Abstract submitted to the 22nd Congress of the Collegium Internationale Neuro-Psychopharmacolgicum. Brussels, Belgium. 2000.
  • Ghaemi SN, Manwani SG, Katzow JJ, Ko JY, Goodwin FK. Topiramate treatment of bipolar spectrum disorders: a retrospective chart review. Ann Clin Psychiatry. 2001;13:185–189. doi: 10.1023/A:1014627001201. [PubMed] [CrossRef] [Google Scholar]
  • Vieta E, Gilabert A, Rodriguez A, Garcia-Castrillon A, Luna MJ, Arrufat F, Garcia Pares G. Efectividad y seguridad del topiramate en el trastorno bipolar resistente. Actas Esp Psiquiatr. 2001;29:148–152. [PubMed] [Google Scholar]
  • Saxena S, Fieve R. Adjunctive open label topiramate in bipolar disorder. International Journal of Neuropsychopharmacology. 2002;6:56.[Google Scholar]
  • Vieta E, Torrent C, Garcia-Ribas G, Gilabert A, Garcia-Pares G, Rodriguez A, Cadevall J, Garcia-Castrillon J, Lusilla P, Arrufat F. Use of topiramate in treatment-resistant bipolar spectrum disorders. J Clin Psychopharmacol. 2002;22:431–435. doi: 10.1097/00004714-200208000-00017. [PubMed] [CrossRef] [Google Scholar]
  • Vieta E, Ros S, Valle J, Crespo JM, Valls J, Salgado P. A multicentre study of the efficacy and safety of topiramate in mania. 23rd Congress of the Collegium of Internationale Psychopharmacologieum. Montreal, Canada. 2002.
  • McInryre RS. An open trial to document the safety and optimal dosing of topiramate as add-on therapy to mood stabilizers in the treatment of subjects with bipolar I or II disorder with unstable mood. American Neuropharmacology Association. 2002.
  • McIntyre RS, Mancini DA, McCann S, Srinivasan J, Sagman D, Kennedy SH. Topiramate versus Bupropion SR when added to mood stabilizer therapy for the depressive phase of bipolar disorder: a preliminary single blind study. Bipolar Disor. 2002;4:207–213. doi: 10.1034/j.1399-5618.2002.01189.x. [PubMed] [CrossRef] [Google Scholar]
  • Hussain MZ, Chaudhry ZA, Hussain S. Topiramate in treatment of refractory bipolar depression. Bipolar Disord. 2001;3:43.[Google Scholar]
  • DelBello MP, Kowatch RA, Warner J, Schwiers ML, Rappaport KB, Daniels JP, Foster KD, Strakowski SM. Adjunctive topiramate treatment for paediatric bipolar disorder: a retrospective chart review. J Child Adolesc Psychopharmacol. 2002;12:323–330. doi: 10.1089/104454602762599862. [PubMed] [CrossRef] [Google Scholar]
  • Gordon A, Price HP. Mood stabilization and weight loss with topiramate: Am J Psychiatry. 1999;156:968–969. [PubMed] [Google Scholar]
  • Carpenter LL, Leon Z, Yasmin S, Price LH. Do obese depressed patients respond to topiramate? A retrospective chart review. J Affect Disord. 2002;69:251–255. doi: 10.1016/S0165-0327(01)00337-8. [PubMed] [CrossRef] [Google Scholar]
  • Millson RC, Owen JA, Lorberg GW, Tackaberry L. Topiramate for Refractory Schizophrenia. AJ Psychiatry. 2002;159:67. [PubMed] [Google Scholar]
Sours: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1088011/

Have been retired for several years). Over time, she even began to transfer money. However, not a word about charity - "let your right hand not know what the left is doing. " In short, today I am. Quite a self-sufficient character in the tragedy called Life.

You will also be interested:

This time we decided to play strip cards, but during the game Kiryukha offered to play for anal sex, motivating this by the fact that he hadnt done this for. A long time. Tanya and Katya lamented that they did not want to do this: What are you, Kiryukh, forget about anal sex with your dick, especially with us.

- said Tanya.



3403 3404 3405 3406 3407