Do we take Topa forever?

I asked this on the discussion board also, but think this might be a better question for you doc.

I have just been wondering how long I should be taking the topamax and how long others plan on taking it? I think RJ said she plans on taking it for life and others say this too.

I hope not to. I went down to 200 mg Sun-Wed and 300 mg Thurs, Friday and Sat(weekends are harder for me).

I remember reading that topamax is supposed to help you with cravings and now that I don't really have any, I am not sure how long I should continue to take it. Right now I am dealing with the habit or pschylogical cravings during the weekend. I just don't think the topamax is helping with that at all.

Of course I am nervous if I stop that I might regress. Any thoughts?

-Nina

Hi Nina.

Just like diabetes or heart disease this requires treatment forever. The medication is one part of the therapy, but sometimes I find people overly focused on them. The body has the inner power to heal and this program with its integrated approach maximizes that process. I would recommend you stay on the drugs/medications as long as you need to get back your natural healthy equilibrium. But of course, as you know you can't expect a pill to do everything, there are no magic bullets. Recently we have been discussing and researching the therapeutic value of music and the inner euphoria it releases (along with exercise.) I believe these holistic avenues are truly exciting. In addition, they are a positive alternative to the expensive pharmaceuticals that many people feel are the answer to getting this disease under control.

So derive the power and control you need and then modify the program to incorporate the least amount of medication possible, long term if necessary. Continue with the integrated approach because that is key. Some of my patients have titrated completely off the medicine but for others it is not a safe proposition. I'm curious that many patients don't necessarily ask me how long they have to do the positive visualization, pulse related exercise, nutritional part of the program, etc.

It looks to me like you have customized the medicine level so it is working well. If you reduce the dosage while incorporating the other integrated therapies in this program and feel the cravings return, it's probably time to re-assess your needs regarding medication. There are also other therapies to consider such as acupuncture, enhanced nutritional supplementation, etc.

You are also correct about the psychological cravings and habit. It takes more than a prescription to address this but I think you are off to a very good start.

Good question Nina and I hope this helps.

--Dr. Garcia