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Suggest medication for bulimia and alcohol dependence

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Posted on Fri, 6 May 2016
Question: hello,
I am wanting to know if there is a (safe) drug to help with Bulimia?
I have heard of Topamax but believe it has side effects.
I am on Antabuse for alcohol dependence (which I have overcome).
Would there be something that could help with both conditions?
I would be very grateful of your suggestions.
Thank you,
xxxxx
doctor
Answered by Dr. Chintan Solanki (2 hours later)
Brief Answer:
yes you can try

Detailed Answer:
Hello XXXXXXX

Thanks for writing to us.

Yes you are right that topamax has some side effects. However each drug has its own side effects. It does not mean that each side effect occurs in every patient. Only 10-20% patients suffer from side effects and that is also not all side effects. Many side effects go away within a week.

Topamax is good drug for both alcohol deaddcition maintenance as well as reduction in weight. Being an anti epileptic drug it can cause some side effects like Dizziness, fatigue, nervousness, paresthesia, psycho motor slowing, visual disturbance, nausea, confusion, memory problem but these are not there in general in low dose.
Reduce appetite is common side effect and that is used for weight reduction.
Starting with low dose like 12.5 or 25 mg and gradually increasing the dose as per need will help to keep side effects away.

I recommend trying it as it can be used for both purposes in your case. Go ahead after meeting with your treating doctor.

Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (6 minutes later)
Thank you very much Dr. Solanki,

I appreciate your detailed reply.

Would there be another/better/safer drug to use, other than Topamax?

Kind Regards,

xxxxxx

doctor
Answered by Dr. Chintan Solanki (6 minutes later)
Brief Answer:
Anti depressant medicine from SSRI group- fluoxetine

Detailed Answer:
Dear XXXXXXX

Drugs from SSRI group and of them fluoxetine (prozac) is safe and good alternative. However with medicine, psychotherapy specifically cognitive behavior therapy (CBT) is useful tool to treat bulimia.

Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (22 minutes later)
Thank you again,

One other thing I would be grateful for your guidance about is a side effect I feel is coming from the Antabuse -
i.e. tingling in my hands (very noticeable)
Today I have noticed a bit in my feet.
(I have only been on Antabuse for approx. 3 - 4 weeks.

Is this a dangerous side effect?

Sorry to be asking you these questions but my own doctor is on holidays.

Thanking you again.

xxxxxx
doctor
Answered by Dr. Chintan Solanki (1 hour later)
Brief Answer:
Not dangerous at all

Detailed Answer:
Hi XXXXXXX

No need to sorry as you are using service and I should answer.

Tingling is not a serious side effect. However It should be stopped after 1 month of absence of antabuse. If it persists I suggest evaluation for B12 deficiency or any neuropathy changes.

If still any query there, I will be happy to answer if not, you can close the discussion and if feasible give your feedback and rating so I can improve my service.

In future if you wish you can contact me directly on this site with following link:
http://bit.ly/drchintansolanki

by clicking on 'Ask me a question' on same page with three follow up questions.

Wish you good health dear.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (46 minutes later)
Thankyou again for your reply,

Just one more question!!

What causes the tingling, when on Antabuse??

Thanking you again.
doctor
Answered by Dr. Chintan Solanki (39 minutes later)
Brief Answer:
it is a neurological side effect

Detailed Answer:
Hi,

Thanks for question.

Peripheral neuritis and peripheral neuropathy are common side effects of Antabuse. Tingling is the symptom of that side effect. However with chronic alcohol use peripheral neuropathy is very common and sometime it appears after stopping alcohol and starting antabuse.

In any case it should be treated with multivitamins specifically benfothiamine, methylcobylamine and pregabalin/gabapentin depending upon severity.

You are welcome to clear any doubt if it is still there.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Chintan Solanki (13 minutes later)
thank you again,

could you just tell me the 'common' names for those vitamins -so that I can look out for them and get onto them.

Thank you so much for your help.

xxxxxxx
doctor
Answered by Dr. Chintan Solanki (2 minutes later)
Brief Answer:
I have mentioned common name only

Detailed Answer:
Hi,

Benfothiamine or benfotiamine (vitamin B1) and Methylcobylamine (vitamin B12) are common (generic) name of supplement. While pregabalin or gabapentin is prescription drug.

You are welcome XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Dr. Chintan Solanki

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Suggest medication for bulimia and alcohol dependence

Brief Answer: yes you can try Detailed Answer: Hello XXXXXXX Thanks for writing to us. Yes you are right that topamax has some side effects. However each drug has its own side effects. It does not mean that each side effect occurs in every patient. Only 10-20% patients suffer from side effects and that is also not all side effects. Many side effects go away within a week. Topamax is good drug for both alcohol deaddcition maintenance as well as reduction in weight. Being an anti epileptic drug it can cause some side effects like Dizziness, fatigue, nervousness, paresthesia, psycho motor slowing, visual disturbance, nausea, confusion, memory problem but these are not there in general in low dose. Reduce appetite is common side effect and that is used for weight reduction. Starting with low dose like 12.5 or 25 mg and gradually increasing the dose as per need will help to keep side effects away. I recommend trying it as it can be used for both purposes in your case. Go ahead after meeting with your treating doctor. Hope I have answered your query, I will be happy to help further. Regards, Dr.Chintan Solanki.