Contributing factors to depression - anybody take topamax?

[joeylittle]

That's great news, @whiteraven - thanks for coming back and giving an update.

Something I noticed when I was trying Lamictal - I've no idea if you'll have a similar experience - as we were trying to figure out the right therapeutic level, we ended up overshooting just a bit. That's not uncommon. But, my reaction to the over-shoot was not great. It was why I ended up giving up on that one.

You'll hit a point where you/your doctor are wondering whether you should continue to titrate up on the Lamictal. My advice would be, if things are in a decent place and holding steady, just stop for a bit, and see if it'll stay that way, as opposed to inching the dose up even further. If/when you do decide to try and increasing the dose past that point, ask your doc if it's OK to do it in even smaller increments (as I recall, Lamictal seems to take forever to increase, because of the wait time inbetween and the smallness generally of the amount).

I wonder, sometimes, if I should have kept trying to work with it. But the problems I was having, once I got past my dosing threshold, were not insignificant, and it took awhile to realize what was happening. So, I was more eager to get off of it altogether just to resolve the problems.

Just some two-cent's-worth of thoughts; truly, my main intention in posting was to just say I'm really glad for you, that it's working out. And good job with having the patience and tolerance to make it through the tough part of the 'waiting for the new drug to kick in', especially with Lamictal, since it's such a slow-goer.

 

[whiteraven]

That's great news, @whiteraven - thanks for coming back and giving an update....

Thanks, @joeylittle! Wondering what kinds of issues you had with Lamictal, if you recall?

I think the reason I've been able to stick with it is because I really don't want to be on the Topamax and my neuro told me there were no other options. There are, but to explore them I would have to find a new doctor and I'm just not up to that right now. So...here I am! LOL I really wasn't expecting the other benefits I would get from it (significantly reduced depression - although it's hard to say how much is that and how much is the decrease in the Topamax), but I'm definitely not complaining.

 

[joeylittle]

Wondering what kinds of issues you had with Lamictal, if you recall?

I was struggling to find something that would help with the bottom end of my depression (I have a separate MDD diagnosis, and all this was prior to when I presented with PTSD). Abilify had worked, but was causing unstoppable weight gain. Lamictal was to replace the abilify. It first, it did do a good job - my lows were not so bad, and I could start to effectively CBT/DBT my way out of them.

Because it's such a slow titration, I did not notice that I was also having two problems. One, I was becoming more detached from all difficult emotions, including guilt and fear. At the time, I relied on guilt and fear to help with chronic suicidal ideation. Not a great way to manage those thoughts, but no medication or treatment protocol was dealing with them. I didn't actually recognize them yet as a symptom of their own, I just lumped them into the depression thing generally. So - I discovered with Lamictal it wasn't so much that I wasn't still having those thoughts - I was - it's just that they were no longer occurring as a result of being deeply hopeless. They were happening even while I was less low. But it no longer seemed as frightening to me, nor did I have any of the sense of human responsibility to keep trying to live. None of the negative thoughts (fear of death, guilt over giving up) had any sharpness anymore, and death started to seem like no big deal.

Two, I was having the short term memory loss side effect, and it got worse as we bumped the dose up. In the work I do (and I was working at the time), I use short-term recall a lot. So, it was slowing me down. I also had the hand tremors that can be a side effect, and I need a reliable level of manual dexterity to work effectively.

I would have figured out how to cope with the side effects, if everything else was working. But the numbing effect was not going to be sustainable long-term. So, we came off of it again. As I was getting off of it I was really surprised to discover how much slower I had been thinking and speaking. So, overall, it wasn't the best solution for me. I ended up going back on abilify, and then eventually changing my main med from cymbalta to effexor, and then getting off the abilify again. The effexor did a better job of managing the bottom end of things.

A few years later I did try topomax - my psych put me on it not so much for the depression help, as for the weight-loss side effect. i didn't get the side-effect, but I did get dopey again (slow), without any help with mood. Kind of all of the bad and none of the good. So, that was short-lived.

 

[whiteraven]

Thanks for your detailed reply @joeylittle. I have finally started to get some sleep, although I'm still waking early. I've had some very manic-like episodes since starting the Lamictal, esp. lately; I'm not sure my therapist knew what to think, since I'm usually fairly quiet during session and it's hard to talk. Yesterday I jumped around so much we must have talked about 50 different things in the hour I was there. LOL

I'm better today. One thing I've noticed is that my hair is falling out again. I noticed that on Abilify - psychiatrist said it wasn't possible, but I stopped it and my hair quit falling out - and was so sad, because Abilify really helped me. Over the years with all the meds I've been on, my hair has really thinned out a lot. I'm hoping I don't have to stop the Lamictal too soon, because I don't want to go back on Topamax and it really is helping the depression.

nor did I have any of the sense of human responsibility to keep trying to live. None of the negative thoughts (fear of death, guilt over giving up) had any sharpness anymore, and death started to seem like no big deal.

Wow. This sounds familiar. I have had this for the last ?3 years. I also have a MDD diagnosis - dx a long time ago, prior to the PTSD. The Lamictal and Effexor seem to be helping with that, though. At least most of the time.

 

[whiteraven]

Have had some seriously up-and-down days since I last posted to this thread. I determined that my manic-like behavior/feelings and inability to sleep were related to withdrawal from the Topamax (which I think was done too quickly, given how long I'd been on it and how much I was taking) - why don't doctors tell you about this stuff??? I was only getting at most about 3 hours of sleep a night and so felt physically horrible (although mood-wise, much better) most of the time. On Christmas Eve, I didn't go to bed until 630am Christmas morning. Yeah...it's been fun.

I finally called my neuro and talked to whoever is covering for him while he's off. He's reintroduced the Topamax at a smaller dosage and given me another schedule to taper off of it. I've been on it a week now and I can't believe the difference. Intensely depressed, very low energy. But more than anything, I notice I just kind of sit and stare and I can't make myself *move*. This is how I've been for years. And now there is just no question in my mind it was my reaction to the Topamax.

Feeling really *angry* lately because I've lost so much to this medicine. I didn't realize, so it doesn't feel like it was my choice.

 

[2Beachboxer]

Everyone reacts differently to medications. Many people may not get that side effect or any of them....

I agree. I can't comment on My Topamax dose, or how it affects me compared to you. Different dx doses weight metabolism. Apples and oranges. Best to talk to pharmacy and doctor.

 

[whiteraven]

I agree. I can't comment on My Topamax dose, or how it affects me compared to you. Different dx dos...

For me, talking to my doctor(s) resulted in me losing *years* of my life due to this medicine.

I absolutely agree that medicines - ALL medicines - affect people in different, individual ways. But I have learned over the years that it is critical to do your own research, listen to others who take the medicines, and compile as much data as you can when considering a drug, instead of relying ONLY on your doctor.

 

[2Beachboxer]

Yes, we also must be good advocates for ourselves. I sincerely do Not see doctors as God's. They are humans who may or may not have kept up with New research/education. Big Pharma supplies what they want..

 

[EveHarrington]

For me, talking to my doctor(s) resulted in me losing *years* of my life due to this medicine.

I ab...

Yes, it is VERY important to do our own research. Here in American culture, it’s a MUST! I know this is not so in foreign nations as it never fails that when I post a med question, someone outside the USA says to to just ask my doctor. Well you know what? Doctors don’t know everything. They also go by literature, the drug trials which don’t always reveal side effects that show up with much more prevalence when released to the general public. Doctors and pharmacists have their place, but the internet will tell us all we need to know as long as we’re using the right search terms and taking in a balanced view. f*ck, my new MOOD STABILIZER (not Topamax) is causing very happy feelings and mood crashes. My dose has not stabilized yet. I can’t even find anything online about this effect, so I’m not all that confident that my doc will know what I’m talking about when I see him tomorrow. But, at least I did my research.