Side Effects of High Dose Topamax

What the Docs May Not Say -- or Know

Topamax (topiramate) is an anti-convulsant medication that can be prescribed for a number of conditions. Bipolar disorder is not among them, but its off-label use as a mood stabilizer is known. There is no recommended dose for treating manic depression, but some physicians have experienced "success" at doses that are four times those given for other conditions.

Anxiety, agitation, depression -- these are just a few symptoms can be caused and/or exacerbated by Topamax, yet they can be symptoms of bipolar disorder as well. Will a physician misdiagnose these side effects as part of a patient's inheritent condition, and consequently prescribe more medication to mitigate what the Topamax has caused?

A standard Topamax dose is 400 mg./day, yet doses as high as 1,600 mg. per day have been prescribed for bipolar disorder. It can cause osteoporosis and vision problems, among other things, yet no limit has been set on the prescription dose allowed. Prior to January 2009, when a generic version became available, a prescription for 1,600 mg. cost insurance companies and consumers over $2,000 a month. Is this why no warnings or limits about high doses were established?

Television is full of commercials for medications. Smiling consumers walk on beaches at sunset, play with their children and dogs, row happily toward a secluded cottage on the shore. As we gaze at these images of health, a narrator reads a long list of side effects. Pictures tell us all will be well; a voice lets us know it might not. Is the public becoming more aware, or simply desensitized to hearing these precautions?

There can be a fine line between enlightened participation in one's health and putting one's trust in a physician. If obtaining medical expertise was as easy as following a few links on the internet, we might have doctors with degrees from Google, or Wikipedia. But it's not, and we don't. In the end, most elect to listen to the medical pros -- doctors beseiged by drug company reps, advertising, and samples of medications. In most cases, the only information a patient will have when handed a prescription is what the doctor conveys.

If your doctor prescribes a high dose of Topamax to treat bipolar disorder, ask questions. And be aware that this medication can cause or make worse the very symptoms you are trying to avoid.

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