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Topamax for bipolar disorder and weight loss

Topamax™ (topiramate) is FDA-approved as a treatment for epilepsy but it is commonly prescribed for bipolar disorder to be added to other bipolar medications. This anticonvulsant has been shown in studies to improve symptoms of mania, hypomania, mixed states and rapid cycling. Studies have found that Topamax™ can ease symptoms of bipolar depression; in one, more than half of participants with these symptoms were “much or very much improved.”

Topamax™ comes as a tablet and a sprinkle capsule to take by mouth. It is usually taken twice a day, and is typically started at a low dose which is gradually increased.

Among the drug’s side effects, one may be welcomed by the many people who battle the weight gain that frequently results from bipolar medication: Topamax™ often causes weight loss. In one of these studies, all the patients lost weight, at an average of nine pounds in five weeks; in the other, 60 percent of participants lost weight. The weight loss may come at a cost, however.

Other side effects include cognitive dysfunction; attention, concentration and memory problems; and word-finding difficulty. One bipolar authority writes that Topamax™ has been called “the California drug, because it makes you thin and stupid.” Other adverse effects include fatigue; sedation; temporary tingling, burning or itching skin; nausea; and anorexia; dizziness; nervousness, irritability, sudden changes in behavior or mood; hypoglycemia (low blood sugar); potentially serious vision problems; headache, weakness, seizures and others. As with all drugs, there are risks of more serious, but very rare effects.

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