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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 6 of 6. This is the beginning of the thread.
Posted by Iansf on February 17, 2005, at 14:39:45
Topiramate evaluated
for generalized social phobiaTopiramate (Topamax) may have a role in the treatment of generalized social phobia, Canadian researchers report.
In a 16-week open-label study, 16 adult outpatients (7 males, 9 females) meeting the DSM-IV criteria for generalized social phobia were administered topiramate, 25 mg a day, slowly increased by 25 mg the first week, then increased by 50 mg increments for the following week, up to 100 mg a day at the end of week 3. At the end of week 5, the dose was further increased by 50 mg BID each week up to a maximum daily dose of 400 mg at week 9, depending on tolerability. Efficacy was determined by a Clinical Global Impression-Improvement Scale (CGI-I) score of 1 or 2 (very or much improved) at week 16, and by baseline-to-endpoint change in Liebowitz Social Anxiety Scale (LSAS) scores.
Eleven of 16 patients completed the trial, with five discontinuing the study due to adverse events or lack of efficacy. Among study completers (N=11), seven were considered responders at endpoint, as assessed by CGI-I and LSAS scores (mean drop of 41%). In the intent-to-treat analysis, seven patients were responders by CGI-I, and the mean drop in LSAS score was 29 percent. Repeated measures of analysis of variance (ANOVA) showed significant differences for self-reported measures of anxiety, but not for measures of generalized anxiety or depressive symptoms. The most commonly reported adverse events were weight loss, paresthesias and headache.
The researchers conclude, "topiramate may be effective in the treatment of generalized social phobia and an effective alternative to other drug treatments for [generalized social phobia], particularly for SSRIs." They note, "[topiramate] may have a very specific effect on reducing symptoms of social phobia but not on symptoms of generalized anxiety or depression."
Ameringen MV, Mancini C, Pipe B, et al.: An open trial of topiramate in the treatment of generalized social phobia. Poster presented at the 52nd annual meeting of the Canadian Psychiatric Association, Banff, November 2002.
Posted by Phillipa on February 17, 2005, at 17:23:11
In reply to Topiramate for social phobia, posted by Iansf on February 17, 2005, at 14:39:45
Interesting information. Fondly, Phillipa
Posted by Nixon on February 17, 2005, at 17:58:23
In reply to Topiramate for social phobia, posted by Iansf on February 17, 2005, at 14:39:45
> Topiramate evaluated
> for generalized social phobia
>
> Topiramate (Topamax) may have a role in the treatment of generalized social phobia, Canadian researchers report.
>
> In a 16-week open-label study, 16 adult outpatients (7 males, 9 females) meeting the DSM-IV criteria for generalized social phobia were administered topiramate, 25 mg a day, slowly increased by 25 mg the first week, then increased by 50 mg increments for the following week, up to 100 mg a day at the end of week 3. At the end of week 5, the dose was further increased by 50 mg BID each week up to a maximum daily dose of 400 mg at week 9, depending on tolerability. Efficacy was determined by a Clinical Global Impression-Improvement Scale (CGI-I) score of 1 or 2 (very or much improved) at week 16, and by baseline-to-endpoint change in Liebowitz Social Anxiety Scale (LSAS) scores.
>
> Eleven of 16 patients completed the trial, with five discontinuing the study due to adverse events or lack of efficacy. Among study completers (N=11), seven were considered responders at endpoint, as assessed by CGI-I and LSAS scores (mean drop of 41%). In the intent-to-treat analysis, seven patients were responders by CGI-I, and the mean drop in LSAS score was 29 percent. Repeated measures of analysis of variance (ANOVA) showed significant differences for self-reported measures of anxiety, but not for measures of generalized anxiety or depressive symptoms. The most commonly reported adverse events were weight loss, paresthesias and headache.
>
> The researchers conclude, "topiramate may be effective in the treatment of generalized social phobia and an effective alternative to other drug treatments for [generalized social phobia], particularly for SSRIs." They note, "[topiramate] may have a very specific effect on reducing symptoms of social phobia but not on symptoms of generalized anxiety or depression."
>
> Ameringen MV, Mancini C, Pipe B, et al.: An open trial of topiramate in the treatment of generalized social phobia. Poster presented at the 52nd annual meeting of the Canadian Psychiatric Association, Banff, November 2002.Hi,
Yes, that is interesting stuff. I am sure it does have a positive effect in some people. Unfortunately I personally did not find Topamax very effective for anxiety or as a mood stabilizer. The cognitive impairment was just too much for me at relatively low doses. Thanks for the info though. JN
Posted by Iansf on February 17, 2005, at 18:24:45
In reply to Re: Topiramate for social phobia » Iansf, posted by Nixon on February 17, 2005, at 17:58:23
> Yes, that is interesting stuff. I am sure it does have a positive effect in some people. Unfortunately I personally did not find Topamax very effective for anxiety or as a mood stabilizer. The cognitive impairment was just too much for me at relatively low doses. Thanks for the info though. JN
>
>
Do you know if cognitive impairment is a common side effect of topiramate? Is there nothing to counteract that?
Posted by Nixon on February 17, 2005, at 18:31:57
In reply to Re: Topiramate for social phobia » Nixon, posted by Iansf on February 17, 2005, at 18:24:45
> > Yes, that is interesting stuff. I am sure it does have a positive effect in some people. Unfortunately I personally did not find Topamax very effective for anxiety or as a mood stabilizer. The cognitive impairment was just too much for me at relatively low doses. Thanks for the info though. JN
> >
> >
> Do you know if cognitive impairment is a common side effect of topiramate? Is there nothing to counteract that?
>
Hi,Everything I have read regarding Topamax has had a mention of cognitive impairment to some degree. I did not set myself up with a predisposition of that side effect it was just noticable to me. Perhaps it has a connection to heavy work in the Temporal lobes, I don't know. I do know alot of people are happy with Topamax. JN
Posted by n@oise on February 21, 2005, at 17:47:11
In reply to Re: Topiramate for social phobia » Iansf, posted by Nixon on February 17, 2005, at 18:31:57
T-max is jokingly referred to as the supermodel drug...makes you dumb and skinny. ur right about the temporal lobes bit and as far as a remedy, all us looney toons are meant to be taking omega-3...the pure liquid stuff not generic capsules...it helps keep the brain well oiled, on the stable side.
in terms of how exactly it helps us, i'm having a bit of a moment myself now - so i can't remember the right way to describe it all but it has something to do with neuroreceptors - or transmitters - and the synaptic gap!?!? i think.
other than that, wellbutrin has been known to sharpen things up. my pdoc was gonna script me to help with my lamictal-duh's but may wait cos my cocktail needs to be played with. i'm sticking with the omega-3 for now tho...it's not hurting.
> > >
> > >
> > Do you know if cognitive impairment is a common side effect of topiramate? Is there nothing to counteract that?
> >
> Hi,
>
> Everything I have read regarding Topamax has had a mention of cognitive impairment to some degree. I did not set myself up with a predisposition of that side effect it was just noticable to me. Perhaps it has a connection to heavy work in the Temporal lobes, I don't know. I do know alot of people are happy with Topamax. JN
This is the end of the thread.
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