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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by evergreen on January 20, 2003, at 16:05:22
I take 40mg. of prozac daily. In addition I take 7.5-15mg of remeron at night to sleep. I am gaining weight like crazy (50+ pounds) My question is can I add Topamax at dinner time to offset the appetie increase from remeron. Please answer quickly because I have a dog and I bet He would taste real good with some salt and pepper on himm (Just kidding)....By the way I have very little appetite during the day, but come 4-5 oclock and I can't stop eating.
Ray
Posted by jay on January 20, 2003, at 17:45:17
In reply to topamax, posted by evergreen on January 20, 2003, at 16:05:22
Hi:Yes, there are a few studies that support the use of Topamax for weight loss, especially on an SRI (like Prozac.) Give it a shot,
Jay
Posted by Greg on January 21, 2003, at 19:53:51
In reply to topamax, posted by evergreen on January 20, 2003, at 16:05:22
Hi evergreen,
I've been taking Topamax as a mood stabilizer for a little over a year now at a dose of 200mgs, 100 am, 100 pm. I gained about 45 lbs on Zyprexa. I was originally rx'd Neurontin as mood stabilizer, but it didn't do a thing for me except make me extremely fatigued. After talking it over with my psych, we decided to give the Topamax a go. It has worked great and has carried the added benefit of helping me to lose weight. But...always one of those aren't there? The Topamax alone isn't going to do the trick unless you have one of those amazing metabolisms. You'll need a good solid, healthy diet and an exercise program to go along with it if you want to make it work. If you like chicken, that's a real good food to work into a diet, but stay away from carbohydrates. The Topamax by itself will help take off some of the weight, but I doubt seriously that it will take off the amount you're talking about.
Here's the drawback to Topamax. It should be titrated up or down at very low doses, usually 25 to 50mgs at a time. This is because in most people it causes Cognitive Dulling, or what I call "A case of the stupids". Everytime my dose was increased I would have trouble spelling words, keeping my thoughts straight, 2+2 equalled 5, stuff like that. It only lasted for a few days, but it's still a pain in the butt. When you reach your target dose and you're on it for a bit, this does all go away, at least it did for me. The upside is that I have found it to be an excellent mood stabilizer, and out of the 45 lbs I gained, I've lost 41. There's usually some kind of a trade-off with any med that you take, and Topamax is no exception in my experience.
Well, that's my story and I'm stickin' to it. I wish you all the best of luck with this and I hope you'll let us know how it works out for you.
I hope this info helps.
Greg
Posted by Madge on January 24, 2003, at 15:09:27
In reply to Re: topamax » evergreen, posted by Greg on January 21, 2003, at 19:53:51
Hi, check out the threads that were started in Dec 2002 about this very subject. They have been very helpful to me. I just added my updated comments yesterday as I have added Topamax to my regiment to lose the added weight I gained on Remeron. Remeron is the worst for weight gain initially supposedly because of the antihistimine effect. It stops at about 8 weeks but you can't take off the weight you've gained without help. There are articles posted on the internet and psychobabble about the research for adding Topamax to AD treatment. Just make sure you have a good psychopahrmachologist who titrates you VERY slowly to avoid the cognitive problems ie 25 mg at a time. to help you find the right dose to lose wieght and of course you get the added benefit of it being a mood stabilizer. Also Topamax is very sedative in the beginning. I found that when I added 25mg to hit 100mg it was brutal for sedation for a few days then I got used to it. Now at 125 mg, adding the 25 mg the first day was hard and day two I'm fine. This is not a drug to be taken lightly. It takes diligence, patience, and perseverence to find the right dose. Some days you can't predict how your body will respond to the added dosage. All in all, I am willing to hang in there because the side effects have not been that bad for me. I had so many other awful side effects on other AD's that finding Remeron and dealing with the Topamax for the weight gain is so much better than all the other things I had to deal with in the past.
Good luck.
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