Posted by ed_uk on April 23, 2005, at 18:19:09
In reply to Topamax (topiramate) Toxicity, posted by ed_uk on April 23, 2005, at 17:56:02
OK, loss of appetite is a frequent side effect of Topamax. Loss of appetite is one of the symptoms of metabolic acidosis. Could it be that Topamax reduces appetite simply by inducing metabolic acidosis- a biochemical derangement? This would *not* be a healthy means of losing weight!
Topamax is a carbonic anhydrase inhibitor. Acetazolamide is a carbonic anhydrase inhibitor which is used to treat glaucoma.
Topamax and acetazolamide *share* many side effects, some (but not all) of these side effects may be the result of metabolic acidosis.
Common side effects shared by Topamax and acetazolamide...........
Taste disturbances, loss of appetite, weight loss, paresthesia (numbness/tingling), fatigue, kidney stones etc.
Have a look at this.........................
Carbonic anhydrase inhibitor side effects. Serum chemical analysis.
Epstein DL, Grant WM.
Multiple serum chemical values were examined in 92 patients with chronic glaucoma who were treated with the carbonic anhydrase inhibitors (CAIs) acetazolamide or methazolamide, seeking relationships between serum composition and symptomatic side effects. Of the 92 patients, 44 complained of a symptom-complex of malaise, fatigue, weight loss, depression, anorexia, and loss of libido, which we have found most commonly to threaten continuation of therapy. Patients who had this symptom complex were significantly more acidotic than those without it. Ten of 24 patients who had chemical evidence of excessive acidosis reported a dramatic alleviation of symptoms when sodium bicarbonate was administered.
...........In this study, patients' acidosis was treated with sodium bicarbonate, therefore relieving the side effects. Potassium bicarbonate might also be useful.
I wonder.........
..........to what extent could Topamax's side effects be relieved by treating drug-induced acidosis with sodium bicarbonate? (or potassium bicarbonate).........
..........Would this prevent Topamax-induced kidney stones?
Also, might a sodium/potassium bicarbonate supplement prevent Topamax from causing weight loss??? If it did, this would suggest that Topamax causes weight loss by inducing metabolic acidosis.
Metabolic acidosis can be dangerous- as described by Health Canada. Osteoporosis is a potential risk. It may be advisable to monitor clinical chemistry while taking Topamax. If significant metabolic acidosis is detected, several options are available.........
Reduce the dose of Topamax
Discontinue Topamax
Treat the acidosis with sodium bicarbonate and/or potassium bicarbonate..............................................................................................................
Zonisamide (Zonegran) is another anti-epileptic which is known for causing weight loss. Zonegran is also a carbonic anhydrase inhibitor! Metabolic acidosis has been reported with Zonegran.
'Three cases of hypoactivity and poor appetite with zonisamide-induced metabolic acidosis'
Ed.
poster:ed_uk
thread:488447
URL: http://www.dr-bob.org/babble/20050423/msgs/488459.html