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On fluoxetine along with topiramate. Started getting angry and frustrated. What's wrong?

Nov 2013
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My wife is a long term user of fluoxetine for depression. However, she has recently (6-8 weeks ago) also been prescribed Topiramate for her migraines. She is taking them both and it has coincided with a significant change in her mental temperament. She is angry and frustrated permanently with almost everyone and everything. Could this be due to the Topiramate or the combination of topiramate with the Prozac?
Posted Fri, 28 Dec 2012 in Medicines and Side Effects
Answered by Dr. Sudhir Kumar 3 hours later

Thank you for posting your query.

The current change in your wife's temperament and behaviour is most likely related to the use of Topiramate.

Topiramate has no significant interaction with Prozac, and the combination is safe.

However, as your wife is having adverse effects with Topiramate, it may be wise to discontinue it.

The best anti-migraine drug for her could be divalproex sodium, as in addition to migraine prevention, it also has a favourable impact on mood disorders.

Please discuss these issues with her doctor.

I hope it helps. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
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