Faith,

I asked the same weight loss doctor his opinion on efficacy of Topamax, and if it works when taken a second time after stopping for some time.

Here is his response.

———————-

“In my experience I believe Topamax is a great adjunct for weight-loss especially when combined with anorectic agents [ such as phentermine ].

“I use it primarily in patients who have plateued in spite of taking combination anorectic/SSRI medication [ serotonin reuptake inhibitors ]; or other combinations using SNRI’s [ serotonin / noradrenaline reuptake inhibitors ] and or Glucophage [ metformin ].

DOSAGE—150-200 mg

“Most patients I find will need 100-150 mgs for good weight-loss although dosing can vary from 50 mg to 400 mg.

“I find that most patients who can tolerate the drug will lose weight.

Dropouts Due To Side Effects—15-20% of Patents

“Unfortunately, 15-20 % of patients have cognitive or other side effects resulting in discontinuation.

“Sometimes we will compromise on dosage, and thus weight-loss, thus causing fewer side effects.

No Less Effective When Tried Again

“I haven’t seen tolerance to Topamax in patients who restart after a hiatus.

Start With A Low Dose—25 MG—And Slowly Increase

“The key is to begin at low dose (ie 25mg) and titrate [ increase the dose ] gradually.

“Thus if someone was previously on 300 mgs and doing well it could take a number of weeks once retarting to reach therapeutic dose.

It May Take Several Weeks For Weight Loss To Start In Someone Starting Topamax A Second Time

“Finally, since being overweight/obese is a progressive and chronic disease, patients restarting a program who weigh 20-30 pounds more than a previous visit may experience weight stabilization for several weeks before weight-loss begins.”

Larry,
Once again, I truly appreciate your response.  This is extremely helpful.  I have only been on Topamax again two weeks after checking my records, so that is not much time to know if it will work again for me.  The experience I have had with Topamax regarding my migraines has been life changing as well because I had migraines with visual disturbances that are heriditary.  I have 3 children, one who is pre-school age.  I would be bed-ridden with these episodes and they would happen several times a month.  I could no more control them than I could fly, but they would make me feel like the worst mother in the world! 

I had never had a big weight problem until I developed scarlet fever after catching strep throat from one of my kids.  I had to be put on rounds of steroids and also developed rheumatoid symptoms etc. which made me very inactive.  This made me gain 30-40 pounds.  I only lost this weight after being prescribed topamax.  So, for me this has been a “miracle drug” and trying to understand the way it works is quite fascinating.

I am supposed to be starting my wellbutrin today so I will report my progress back here!  Good luck to all who are on this journey!

I always seem to have a question I forget right after I post!  Maybe it is the topamax! LOL He mentioned it is important to titrate up slowly.  I jumped right back into my full dose without titrating up.  I wonder if it might be helpful to back off and slowly increase back up?  Of course I would check with my dr.  The funny thing is he was totally going off my former prescription and seemed clueless about the medicine and its effects etc.  He didn’t suggest me slowly titrating onto it.  Just kind of “threw me” back on it so to speak.

Faith,

Phentermine Is Vastly Superior To Wellbutrin For Weight Loss

Regarding weight loss…

Most experienced weight loss doctors will tell you that Phentermine is vastly superior to Wellbutrin for weight loss.

Wellbutrin is not every effective at all at causing weight loss, even though there are some studies showing weight loss.

One weight loss doctor told it doesn’t work, and so he doesn’t use it.

Most Doctors Use Phentermine-Topmax Rather Than Wellbutrin-Topmax

Therefore, most weight loss doctors I know who use Topamax for weight loss, combine it with phentermine rather than Wellbutrin.

Phentermine Has An Antidepressant Effect

Phentermine has an antidepressant effect also even though it is not specifically approved for this.

I am currently reviewing and commenting on a book written by a weight loss doctor.

He uses stimulant-type drugs like Phentermine for depression.

Regarding Titrating Slowly

Regarding titrating Topamax slowly…

I think the doctor does this to reduce the side effects of Topamax.

If the full dose is not bothering you, then I assume there is no need to lower the dose and then increase it gradually.

If it is bothering you, then you might want to do this.

faith1109 - 04 May 2010 11:25 AM

Larry,
Once again, I truly appreciate your response.  This is extremely helpful.  I have only been on Topamax again two weeks after checking my records, so that is not much time to know if it will work again for me.  The experience I have had with Topamax regarding my migraines has been life changing as well because I had migraines with visual disturbances that are heriditary.  I have 3 children, one who is pre-school age.  I would be bed-ridden with these episodes and they would happen several times a month.  I could no more control them than I could fly, but they would make me feel like the worst mother in the world! 

I had never had a big weight problem until I developed scarlet fever after catching strep throat from one of my kids.  I had to be put on rounds of steroids and also developed rheumatoid symptoms etc. which made me very inactive.  This made me gain 30-40 pounds.  I only lost this weight after being prescribed topamax.  So, for me this has been a “miracle drug” and trying to understand the way it works is quite fascinating.

I am supposed to be starting my wellbutrin today so I will report my progress back here!  Good luck to all who are on this journey!

Faith, Thank you so much for sharing your story. And I hope all is going well for you.  I was wondering how it was going so far? I gained weight in a similar manner on steroids, about 30-40 pounds. So, I was wondering if you have had any success?  Also, I was wondering, Larry, if any of the Dr’s got back to you specifically on Faith’s question on the titrating up to the correct dose/just starting on the final dose immediately…Is titrating mandatory?  Or is it just to give your body time to adjust to the side effects?  I heard elsewhere, but don’t have a link now, that titrating may be mandatory to prevent seizures which can occur from starting at too high a dose too early.

Yes, he says titrating—that is, increasing the dose slowly—is very important.

If you stopped the drug for a while, then the dose needs to be slowly increased again.

I think only one things is going to help in losing weight is cut off your sweets and oily things and just switch to fruits and boiled vegetables, walk few miles, exercise for few hour and you’ll reduce like anything.

Good Evening,
  Ive been taking abilify for over 7 years now and gained execive amount of weight, I was just put on Topamax this friday. Im bipolar and was put on it for My moods and anxiety. So will see How it helps in the future.  Hes winging me off abilify. I will be taking 200 mg of topamax a day and I start at 25 or 50 and go up weekly.  Im so hoping it will compress my eating as well with abilify I eat all the time.

thanks