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Old 01-27-2019, 11:22 PM
AspiringAuthor AspiringAuthor is offline
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Member Since: Oct 2017
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Default Re: Any Idea Welcomed

Laurie,

the options are as follows:

Naltrexone, Topamax, Zonegran, Wellbutrin. That, assuming that you were taking Seroquel for Bipolar and cannot take combined medications with Topamax because the other ingredient can cause mania.

So, of the above, the most effective is Zonegran. Unfortunately, I could not tolerate it - it produced severe mania and a skin reaction on my face.

I could not tolerate Naltrexone because it produced a depression.

I could not tolerate Wellbutrin because it caused insomnia.

I am, knock on wood, tolerating Topamax second time I am trying it, and it is an amazing medication in that it helps the remainder of my racing thoughts that even Zyprexa could not control and has returned my Zyprexa-propelled appetite to normal even at a small dose (and I am slowly titrating Topamax up). I have lost a tiny bit of weight without exercise, but it is too soon to speak of results since I only started recently.

Naltrexone and Wellbutrin, while causing side effects, did nothing to the enormous and pathological hunger that Zyprexa caused.

When I tried Zonegran, I was not on Zyprexa - I was on Geodon, so I took it hoping to prevent migraines and to lose weight rather than to control appetite and it caused mania so fast that I did not have time to notice its effect on appetite.

These four are the options among the neuropsychiatric medications. Zonegran and Topamax are originally anticonvulsants; both are used in migraine prevention. Naltrexone is primarily a drug for addictions. Wellbutrin is a antidepressant in a class of its own. Topamax and Wellbutrin are combined in a weight loss medication called Contrave, but I always prefer having separate medications because you can fine tune dosage.

I deeply regret going off Topamax when I tried it first time in 2012 - had I not done it, I would not have gained 85 trying various other meds. I stopped it when I did not have a consistent pdoc and was myself uneducated, so when I started having side effects, it did not occur to me to try lower dosages, read up etc. Now I know what i was doing wrong, so here goes:

With this drug, it is imperative to drink copious liquids. Meaning - drink a lot of liquid and then some more. Drink as much as you can and then some, to keep it safe. This will prevent dizziness and some other side effects. And, titrate up ever so slowly. Topamax comes in 15 mg sprinkle caps - you take 1 tbsp of apple sauce, open a capsule, sprinkle the contents onto apple sauce, eat it at once, and then drink some liquid. Do that for a couple of weeks. If you can tolerate that, Topamax also comes in 25 mg tabs, so get those and take 25 mg at night and no sprinkle caps. If you can tolerate that, stop 25 mg tabs and go back to sprinkle caps, but take two - one at night and one in the morning. This way you will be taking 30 mg. Then 25 mg tab at night plus 15 mg sprinkle in the morning = 40 and finally 50, if you can tolerate it. 50 mg is as effective for weight loss as higher dosages, so this would be your goal. Go slowly - you have no emergency. What is out online about titrating by 25 mg once a week is for epilepsy when there is a pressing need to go up fast - you do not have it and please allow the body to slowly grow used to the drug. Topamax is effective in preventing weight gain from Zyprexa, and as weight-gaining antipsychotics go, Zyprexa is even worse than Seroquel, so it would make perfect sense for you to try Topamax. Of course, if you can tolerate Zonegran (my reaction to it was highly unusual, though not unique), even better - the mean weight loss from Zonegran in one study was twice that from Topamax. Worth trying. Wellbutrin is less effective than Topamax. Given the relative effectiveness, I would start with Zonegran - in most people it causes no neuropsychiatric side effects.

I think it is only fair that a problem caused by a pharmaceutical medication should have a pharmaceutical solution - think of it as an antidote.

I am even heavier than you are - about 262 lbs at 5'5'' and some of it, though not the majority, comes from Seroquel as well. My weight pre-meds was around 140.

Metformin did not help me lose weight when I was not on Zyprexa and did not help prevent weight gain when I was not on Zyprexa. My internist does not want me on it now. But some doctors routinely prescribe Metformin to everyone who takes Clozapine or Zyprexa.

I hope you find something that at least halts further weight gain. You certainly deserve a break!
__________________
Bipolar I w/Psychotic features

Zyprexa Zydis 5 mg
Gabapentin 1200 mg
Melatonin 10 mg
Levoxyl 75 mcg (because I took Lithium in the past)


past medications: Depakote, Lamictal, Lithium, Seroquel, Trazodone, Risperdal, Cogentin, Remerol, Prozac, Amitriptyline, Ambien, Lorazepam, Klonopin, Saphris, Trileptal, Clozapine and Clozapine+Wellbutrin, Topamax

Last edited by AspiringAuthor; 01-27-2019 at 11:51 PM.
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