View Full Version : Topamax, advice, PLEASE!!!

01-19-09, 07:57 PM
Okay, so here's the deal: I'm on Lamictal, Seroquel, Focalin, and then Topamax got added a month and a half ago. I have a LOT of neurological issues from a TBI, and also mushy BP-NOS which is just inextricable from the TBI issues, and also severe PTSD of very long standing. I did well on 75 mg. Topamax, and had quite a bit of cognitive improvement (which I still have). This is actually borne out by a series of studies that show that at least some of the effects of stimulants are enhanced by Topamax. The thing is, though, that at 50 mg., I had a LOT of anxiety, and at 100 mg. I have a lot of anxiety. However, the situation is very muddled by the fact that I'm starting to do very serious work on the PTSD. I really don't know how to tease apart the effects of that from the effects of however the Topamax might be interacting with the Focalin, but it does seem weird that at 75 mg I wasn't getting anxiety, and at both 50 mg and 100 mg, I am. I REALLY want to stay with Topamax if at all possible-- I like it for a lot of reasons. A big one is that it finally stomped on some neurological issues that no other med I've ever tried has been able to touch. Another is that it did some serious work on my PTSD and finally dragged it out into the open. I don't want to give those up.

So here's my question: has anybody tried Topamax along with a stimulant? Ritalin, Adderall, Provigil, or anything else? If you did, what was your experience? Did it increase your anxiety at any dose? Did you find a dose that worked? This may be too much to hope for, but has anyone had the experience of trying Topamax with a stimulant while having ADHD and comorbid PTSD?? All advice is appreciated!

01-20-09, 11:12 AM
Unfortunately most Docs don't know/won't tell you that Topa has a very strange side effect profile. Side effects at one dose will disappear at the next level and then reappear yet again. Numbness and tingling are two of them that do that. Wife was not warned of this and freaked out. Another doc took the time to explain it. If you don't need it for siezures, you should spend a month or two at each dose(Titration) until you get to the level that is theraputic for you. The goal is not 100mg, it is to get to where it is good for YOU. Mental confusion is almost guaranteed at some point if you rush it. If 50 is good for you, stay there. If you keep having problems, see a Neuralogist that has EXPERIENCE with this drug.
Sounds like you are on a lot of stuff, I hope you have coordinated care.
Enjoy, Ken

01-20-09, 01:17 PM
Thanks so much for your advice and help. :)
My pdoc and therapist know each other and used to work together. Does that count as coordinated care?

The thing is that we really don't KNOW exactly what neurological issues the Topamax might be helping... I had almost all of the symptoms of temporal lobe epilepsy (including violent rages and trying to attack people that I didn't always remember later on, all of which instantly appeared from nowhere after a temporal lobe head injury and literally never happened once before in my life), Lamictal did a number on a lot of them, and the rest basically disappeared with Topamax. Things are creeping back at 125 mg, so that's it-- I have to go down. :( I can't lose that wonderful effect of getting my old ability to concentrate back that I had at the lower doses of Topamax. I was hoping to go high enough on Topamax to get the cutting-down-severely-on compulsive binging, buying, and hair-pulling effects, to be honest. But I can see that I just can't do it right now. Maybe I can try again later, after a month or two back on 75 mg?

Can I ask, did your wife take Topamax at the same time she was taking any stimulant drugs? A big thing I'm trying to find out is if anyone had that particular experience, and if so, if they had that weird paradoxical effect of extremely *improved* cognitive functioning that I did.

01-21-09, 08:30 AM
No, She was takin it with Prozac, 60mg. and Seroquel. When she stepped back down, it was very strange. The side effects for 75 returned, went away at 50, returned at 25, went away at 10. Took her about 45 days to get over it.
Good luck...Ken
After 3 years on the Seroquel, she has figured out that she can do without the Seroquel. Now she is not tired all morning.

Frankie's Mom
01-21-09, 08:56 AM
I don't have ADHD, but I was on Topamax for migraine control and very high doses of Provigil for Narcolepsy.

My experience with Topamax was that it was unpredictable what the side effects would be at different dosages. I can say that I don't remember any increased/decreased anxiety with the Topamax changes, only when the Provigil dosage changed, and then I would eventually get "used" to it.

I think the highest dosage I ever took on Topamax was 100 mg, but I got up to 1000 mg of the Provigil.

01-27-09, 05:25 PM
So here's my question: has anybody tried Topamax along with a stimulant?

Yep. I did, for migraines, with Adderall for ADD. I can't think of any interactions between the two, or at least any effects that were clearly interactions.

Other than the tingly fingers and toes, I felt fine. I slowly went up to 75mg (or thereabouts). Of course the titration masked the side effects (memory & cognitive). They were there, but I did not notice them. Very nasty, but it did seem to help the migraines. After almost two years I stopped. Bye bye brain fog. A bit later I tried it again (w/o titration) and the side effects were much more obvious.

Titration may have its benefits, but it can also be very insidious, masking effects that might otherwise be obvious.

04-06-09, 01:37 AM
I've taken, 100 mg. of Topamax along with 15 mgs. of Adderall, and both, together, work fine, for me.

If I, may suggest, looking into the 'setting', of one's environment, at a specific 'time span', this may help, in determining, if 'contributing stress', may be a contributor.


So here's my question: has anybody tried Topamax along with a stimulant? Ritalin, Adderall, Provigil, or anything else? If you did, what was your experience?

03-11-13, 05:01 PM
I have been taking Topamax in a relatively high dose for several years as a replacement for lithium for bipolar. About two years ago I was diagnosed w/ADD and finally settled into ritalin, short-acting, as the most effective of the stimulants for my condition. Once the particular stimulant and dose were settled upon, this regime was pretty successful. Increased anxiety has not been much of a problem. (Usually anxiety is reduced.) I have decreased my dose of Topamax significantly.