I know they say this isn't really the best mood stabilizer wise, and it is not actually approved for BP disorder.. but honestly I have had great success with it.. It does not make me loopy or dopey at all and keeps me very even (as an adjunct therapy) I have heard it is very very powerful as an anticonvulsant, but of course not the same on BP.. though some people with rapid cycling and other non-traditional forms of BP do swear by it for some reason I have yet to completely understand.. My pdoc doesn't think it is particularly useful for mania in his patients, well he doesn't trust it since it is not approved.. but I have not had any true mania since being on it.. I honestly thought I could drop it, since supposedly it doesn't really do much for bipolar disorder (or so I thought, & with my pdoc's blessing) and tried to with disastrous results.. I have found it great for rapid cycling..

So anyone else find it really helpful & have minimal side effects?

(oh and interesting to note my son who has severe epilepsy, since adding a very small dose of Topamax has been able to drastically reduce his meds & not had a seizure since it has been added which is over a year..)

Here are some older studies I have found:



Comment in:
Bipolar Disord. 2001 Jun;3(3):161.

Topiramate as add-on treatment for patients with bipolar mania.

Chengappa KN, Rathore D, Levine J, Atzert R, Solai L, Parepally H, Levin H,
Moffa N, Delaney J, Brar JS.

Western Psychiatric Institute and Clinic, University of Pittsburgh Medical
Center, PA 15215-2593, USA. chengappakn@msx.upmc.edu

OBJECTIVE: Anticonvulsant agents such as carbamazepine and valproate are
alternatives to lithium in treating subjects with bipolar disorder. Topiramate
(Topamax), a new antiepileptic agent, is a candidate drug for bipolar disorder.
We evaluated topiramate as adjunctive treatment for bipolar patients. METHODS:
Eighteen patients with DSM-IV bipolar I disorder [mania (n = 12), hypomania (n =
1), mixed episode (n = 5), and rapid cycling (n = 6)], and two subjects with
schizoaffective disorder bipolar type, resistant to current mood-stabilizer
treatment were initiated on topiramate, 25 mg/day, increasing by 25-50 mg every
3 7 days to a target dose between 100 and 300 mg/day, as other medications were
held constant for 5 weeks. The Young Mania Rating Scale (Y-MRS), Hamilton
Depression Rating Scale (Ham-D), and Clinical Global Impression-Bipolar Version
Scale (CGI-BP) were used to rate subjects weekly. RESULTS: By 5 weeks, 12 (60%)
subjects were responders, i.e., 50% reduction in the Y-MRS scores and a CGI of
'much' or 'very much improved'. Three subjects were 'minimally improved', four
showed no change, and one was 'minimally worse'. Six subjects had parasthesia,
three experienced fatigue, and two had 'word-finding' difficulties; in all
cases, side effects were transient. All patients lost weight with a mean of 9.4
lb in 5 weeks, and a significant reduction in body mass index (BMI) occurred
too. CONCLUSIONS: Topiramate appears to have efficacy for the manic and mixed
phases of bipolar illness. Other preliminary data suggest antidepressant
efficacy too. Among obese bipolar subjects, the weight loss potential of
topiramate may be beneficial. If controlled trials confirm these initial
results, topiramate may be a significant addition to the available treatments
for bipolar disorder.

Publication Types:
Clinical Trial


&

9: Actas Esp Psiquiatr 2001 May-Jun;29(3):148-52

[Effectiveness and safety of topiramate in treatment-resistant bipolar disorder]

[Article in Spanish]

Vieta E, Gilabert A, Rodriguez A, Garcia-Castrillon A, Luna MJ, Arrufat E,
Garcia-Pares G.

Programa de Trastornos Bipolares. Centro de la Stanley Foundation de Barcelona,
Hospital Clinic, IDIBAPS, Barcelona. EVIETA@clinic.ub.es

INTRODUCTION: This study was conducted to evaluate the effectiveness and safety
of topiramate as add-on therapy for treatment-resistant bipolar disorder.
METHODS: Twenty-one DSM-IV bipolar patients, considered resistant to treatment
with lithium, carbamazepine or valproate, gave informed consent to receive
increasing doses of the novel anticonvulsant topiramate as adjunctive therapy
for their manic (n= 9), depressive (n= 6), hypomanic (n= 3), mixed (n= 2) or
schizoaffective manic (n= 1) symptoms. The dosage of other mood stabilizer drugs
remained unchanged throughout the 6-week follow-up. Outcome measures included
the YMRS, HDRS-17, and CGI scales. Fifteen out of 21 patients completed the
6-week follow-up. RESULTS: Six patients (40% of completers, 29% by
intention-to-treat) were considered responders to topiramate (> 50% reduction in
YMRS or HDRS-17 and a decrease of 2 points in CGI). The drug was less effective
in intially depressed patients. Topiramate was well tolerated and only one
patient discontinued due to side-effects. The most common adverse effect was
paresthesia (n= 2). Ten patients experienced moderate weight loss during the
follow-up. The mean topiramate dose at endpoint was 158 mg/day. CONCLUSIONS:
These preliminary results suggest that topiramate may be a useful therapy for
bipolar disorders, with promising results even in the most treatment-refractory
patients.

(just for those who use it, thought they may like to see these studies..)