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**Guest** · February 18, 2006, 06:36 PM

trouble on topamax

Herosa, RJ here.

I have emailed Dr. Garcia and asked her to look into this question, as it's very alarming. Alarming also is that there *is* no orange 50 mg. Topamax tablet (opaque capsule only) at least that I know of, but perhaps an MD or pharmacist can confirm whether or not this is true. You'll see from this chart that the orange Topamax delivers 200 mg. of the medication. As we've mentioned so many times, it's absolutely critical to titrate up slowly, and of course you already know this.

Is it possible you were given too high a dose and went from 50 mg. to 200 at one time? What does your pill have stamped on it? I don't believe a true generic form is yet available, but I have seen this version from Canada.

I also don't understand the reaction when you attempted to take the subsequent lower dose unless your system has become overly sensitized to the medication because of the earlier incident. (Or you are reacting to the dye in the pill.) You had side effects when you first started with 25 mg. so you may be quite sensitive to the medication in general, although the slow and appropriate titration you followed earlier seemed to work well. I'm obviously unqualified to address the true nature of this problem, but again, I have informed Dr. Garcia of your situation.

Hang in there.

RJ

**Guest** · February 19, 2006, 12:15 PM

trouble on topamax

Thanks for your reply. I appreciated it. My tablet has the letters top on one side and 50 on the other. Regarding the colour my months supply came in a little brown plastic glass bottle and the tint of the container made them appear pale orange. When I read your post I took one out and held it up and you are right it is more yellow so I am sorry for the confusion that caused. I only handled the 50mg tablet once and that was the evening of the attack. Since then I have been trying to get back on the 25mg tablet. Concerning the dye ... I dont know....maybe. I have never been allergic to anything before , drugs , food, creams, jewellry. I know that there is always a first but it doesnt feel likely for my body if you know what I mean but who knows? The one thing I picked up on was the possibility that I have become overly sensitised to the med because of this incident and that is why I cant take it at all now. That is how it feels to me too. In crude layman terms it feels that the 50mg tablet blew or banged something in my body and now when I go near the tiniest amount of the drug my body says no not that again. What I wonder is- how long does this over sensitivity last? If I give my body a break of a few months I wonder could I tolerate it.
I would spend 2006 trying to introduce it crumb by crumb if I thought it would work. Obviously if I was using this drug to treat a minor condition I would bin it and forget about it but I am not. Its been my one passport out of alcoholic hell. It took me years to find this and I dont want to let go. The only good thing I suppose is that I didnt have a life threatening reaction. my airway didnt swell my eyes didnt swell and every test is clear.I didnt blow anything so whatever it was it was only a sensation however bad. Thank you for emailing Dr garcia. I will wait and see what she says as well. Keep your fingers crossed she gives me some glimmer of hope about this drug. Thanks again.

**Guest** · February 21, 2006, 12:28 AM

trouble on topamax

Hi, Herosa.

1. What was it? I thought I was having a stroke but all tests were clear and I am 100% healthy today.

Herosa, you described an incident that sounds similar to the experience of one of my patients. Like you, my patient had taken her medication with coffee (and on an empty stomach) and had very similar results. It sounds to me like you had an adverse reaction--but it wasn't an allergy, and did not involve a seizure. Was your stomach empty when you took the medicine? It could have been the combination of having no food in the gut, a caffeine rush and introduction of Topamax all at once triggering a panic type reaction. The receptors for panic attacks are located in the same part of the mid brain treated by Topamax--and are also affected by alcohol. (I don't know if you had been drinking the night before, but this could have exacerbated the problem). Also, was there a period in which you had run out of the medication, even for a short time? This could mean you hadn't been able to withdraw from it in the most beneficial way and it may have created an adverse effect when you started taking the 50 mg dose.

The "fight or flight" reaction in a panic attack is the same as if the "foe" were completely real to you--your brain receptors don't know the difference. So they wreak havoc throughout your body, affecting cardiovascular, neurological and other systems.

2. If it was a drug reaction why now? Last autumn I could understand it when I started the drug but not now.

You seem highly sensitive to this medication. It's difficult to know for sure, but the conditions under which you took it may be responsible for this event.

3 The attack happened 20 mins after I took the 50mg orange tablet for the first time so I presume its related but I was on 50mg for weeks in the form of two 25mg tablets. Surely its the same thing?

Yes, the dosing should be the same using two tablets, but in answer to your next question, you had established a specific pathway for the medication. Just like an allergy: once the "memory" is there, similar symptoms can occur.

4. And this is the big issue that is killing me. Why cant I get back on the drug? I was sitting comfortably on 25mg for months day after day and now I cant tolerate a crumb of a tablet without having these symptoms.

You may not be able to use this medication any longer, especially if you are still drinking. I can tell you're disappointed, but it sounds like you may want to give some thought to re-defining the program and re-defining your hypnotic messages: e.g. "Life is better for me now that alcohol is out my realm." You can consider using Campral or Naltexone and be aware that a number of new medications are under development at this time. Many individuals in my practice take Campral and find that with the other components of MWO it gives them the power they need to deal with the craving.

Please follow up with a health care provider. I understand you may be in a difficult position to do so, but it's important that you learn what happened here and do not jeopardize your health any further. I would really urge you to let go of the Topamax if it's causing these problems and look to other solutions for getting healthy.

I hope this helps.

--Dr. Garcia

**Guest** · February 22, 2006, 05:03 PM

trouble on topamax

Thank you Dr garcia for your reply. I can imagine how busy you are and I am grateful for the time you took to write this. I was kind of stuck and I was very interested in your reply. It makes more sense to me now. I am very disappointed obviously but c'est la vie and I will take your advice on board. Thanks again-
Herosa

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