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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest A Mood Stabilizer/anti-depressant

i am quitting topomax, which i have taken for the past say four years -- at 50 mg. i have since last week gone down to 25mg. i am feeling shockingly disoriented. i was taking it as a mood stabiliser and for weight loss. It has made me idiotically stupid. What are the symptoms of withdrawal and is there a mood stabiliser or anti depressant other than wellbutrin that does not cause one to put on weight?
Mon, 27 Apr 2015
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Psychiatrist,  's  Response
Hello thanks for asking from HCM for your health related queries

I can understand your concern. Topiramate is a mood stabiliser and you have reduced the doses to 25 mg per day. In my opinion you can wean off the drug by taking the drug on alternate day for about 2-4 weeks and then the drug can be stopped completely. At 25 mg doses the withdrawal would not be very severe and you may suffer mild restlessness, nausea, insomnia for some days but that can respond to low dose of benzodiazepines like clonazepam. The drug can help to prevent the symptoms of withdrawal.

Other than Wellbutrin, anti-depressants like Fluoxetine can be used. The drug can help in depression and is relatively safer in bipolar disorder also (though a little risk of manic switch). This drug doesn't cause much weight gain. Low dose antipsychotic drugs as Aripiprazole can also help to beat such symptoms.

Visit a psychiatrist for detailed evaluation and prescription of these drugs.

Thanks, I hope this helps you. Take care
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Suggest A Mood Stabilizer/anti-depressant

Hello thanks for asking from HCM for your health related queries I can understand your concern. Topiramate is a mood stabiliser and you have reduced the doses to 25 mg per day. In my opinion you can wean off the drug by taking the drug on alternate day for about 2-4 weeks and then the drug can be stopped completely. At 25 mg doses the withdrawal would not be very severe and you may suffer mild restlessness, nausea, insomnia for some days but that can respond to low dose of benzodiazepines like clonazepam. The drug can help to prevent the symptoms of withdrawal. Other than Wellbutrin, anti-depressants like Fluoxetine can be used. The drug can help in depression and is relatively safer in bipolar disorder also (though a little risk of manic switch). This drug doesn t cause much weight gain. Low dose antipsychotic drugs as Aripiprazole can also help to beat such symptoms. Visit a psychiatrist for detailed evaluation and prescription of these drugs. Thanks, I hope this helps you. Take care