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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 9 of 9. This is the beginning of the thread.
Posted by stresser on February 11, 2005, at 14:28:27
Is anyone taking topamax and adderal for bipolar? My daughter is now taking both for bipolar, along with wellbutrin. The doctor is keeping her at a low dosage of topamax (100mg) and 20mg of adderall per day. I don't know why she isn't going up higher on the topamax as she did before. Will the adderall help with mood swings and depression as well as concentratin? She is being put on it for a one month trial, just seeing if her concentration improves. I really don't know what to expect, and have tried to find out by reading some posts, but no luck yet. Can anyone help me out? -L
Posted by med_empowered on February 11, 2005, at 16:14:08
In reply to topamax and adderal, posted by stresser on February 11, 2005, at 14:28:27
hey there! I don't take topomax, nor have I taken it (I'm a trileptal person myself), but I'll post what I know about adderall. Since Topomax has a bad rep for over-sedation and cognitive slowing, I think the doc is trying to counter that with a stimulant (adderall). Sometimes, this works. Adderall does seem to help with the more "emotional" side of add/adhd, in that some people swear by it for mood swings and what not (I personally find it helps me). In terms of the data I could find, most of it is on stuff that can be "objectively" measured and scored--impulsivity, behavior disturbances, grades, etc. I personally think the adderall trial is a good idea, and it may make the BP medicines more tolerable for your daughter and minimize side-effects, if done well. What disturbs me is the Topomax. Most docs turn to this LAST...I mean, after Lithium last. Its great and all, but cognitive slowing is a problem,it has the weird weightloss effect, etc. Sooo...I don't get low-dosing the Topomax when you could do a midrange dose of Lamictal or Trileptal or even Depakote with fewer side-effects (for most people...this could not apply at all to your daughter). If you don't mind, could you fill us all in a little more on your med trials thus so far? How is the Topomax doing, and what kind of side-effects have been noted? Good luck!
Posted by Phillipa on February 11, 2005, at 18:03:46
In reply to Re: topamax and adderal, posted by med_empowered on February 11, 2005, at 16:14:08
How old is your daughter? Fondly, Phillipa
Posted by stresser on February 11, 2005, at 20:51:50
In reply to Re: topamax and adderal, posted by Phillipa on February 11, 2005, at 18:03:46
She is almost 17, and has a binge eating disorder also, so the lithium and other bipolar medications are questionable. We are really walking on a thin line here, and the doctor is trying not to push her in the wrong direction. She is emotionally unstable right now as far as the binge eating problem is going, and therapy is critical, as well and the correct medication. I know topamax isn't the first choice for mood stabilizaion, but the others do tend to cause weight gain, and that's why she's on the topamax. She was on Trileptal, and Zoloft which caused her to gain (she was really hungry) so he moved her back to the topamax and wellbutrin. Trileptal may be in the cards again if the topamax doesn't work out. I am thankful for the encouraging words about the adderall and topamax, I didn't realize that they worked so well together. There is hope, and I will keep my fingere crossed and let you know how it's going. Our computer has a virus, and we will be taking it to the shop this week. I will answer when I can. Thanks so much. -L
Posted by med_empowered on February 11, 2005, at 22:24:02
In reply to Re: topamax and adderal, posted by stresser on February 11, 2005, at 20:51:50
hey! I hope I didn't come across as critical or anything..I'm just curious. I'm sorry about your troubles and the hurdles you and your daughter face...I hope the topomax/adderall combo works well. Good luck!
Posted by stresser on February 12, 2005, at 9:32:52
In reply to Re: topamax and adderal, posted by med_empowered on February 11, 2005, at 22:24:02
You didn't come across as critical at all. How long does it take for the adderall to take effect? Will she notice the medication in a few days? She has the SAT coming up in March, and I am hoping if it's going to help, we will know by then. I am wondering why the low dose of topamax? Does anyone know? -L
Posted by banga on February 12, 2005, at 11:21:55
In reply to Re: topamax and adderal, posted by stresser on February 12, 2005, at 9:32:52
There is also Lamictal--is that on your list? It is weight neutral, it supposedly helps most with the downward depressive swings.
But as I just discussed with someone on the board here, you need to make sure you take it at a high enough dose to have the stabilizing effect.
I had a good experience with it initially, truly stabilizing, but it stopped workinga at the dose i have been on. Many find the effect come back if you up the dose....
Posted by med_empowered on February 12, 2005, at 16:05:49
In reply to Re: topamax and adderal, posted by stresser on February 12, 2005, at 9:32:52
hey! For me, the effect of adderall was immediate--after one pill, I felt better, though I don't know if this translated into any behavioral/cognitive improvements so soon...at any rate, a few weeks or maybe a month into adderall therapy, my close friends and family could observe positive changes and were commenting on them. I think you said she takes 20mgs, right? That's a standard starting dose, but she may require more to feel the full "oomph" of adderall..I personally take 60mgs daily, divided into 2 30mgs doses. As for her low dose of topomax...topomax tends to be a more sedating mood-stabilizer than some of the other available options, and it also can cause more cognitive impairment...my guess is your doc is using it b/c of its positive profile in terms of effects on weight, but is keeping the dose small to minimize any unwanted effects...but that's just a guess. At any rate, I hope all goes well, and if your daughter continues to have pronounced attention problems and/or associated behavioral problems, feel free to ask about upping the adderall or using an "add-on" to enhance it...wellbutrin, provigil, and straterra are the ones I'm most familiar with, and I'm sure there are plenty of other meds that can help people get more out of stimulant treatment. Good luck!
Posted by stresser on February 13, 2005, at 15:45:09
In reply to Re: topamax and adderal, posted by med_empowered on February 12, 2005, at 16:05:49
She is already taking wellbutrin and maybe that will help right away. What I don't undestand is that she was taking 400mg of topamax one month ago before she switched to trileptal. That didn't work out...so she went back to topamax and is only at 100mg? That I don't understand. She will go back in four weeks, so I will ask then. This past week we have felt as if she is getting worse, not better. She has been hostile, unable to deal with authority and wants everything to go her way. If life isnt' how she wants it, everyone has a miserable life around her, and she makes sure of it! Her father and I are looking at each other and saying "who is this girl, and where did she come from?" It's making me panic. Will the adderall help that at all? -L
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