Anxiety Depression Symptom, Bipolar Disorders

TOPAMAX is indicated (FDA approved) for treatment of seizures (epilepsy) and prophylaxis of migraine.

In the United States, regulations of the Food and Drug Administration (FDA) permit physicians to prescribe approved drugs for other indications that its not approved. This practice is called off-label use. Some medications are commonly used off-label than for its original, FDA-approved indications.

Topiramate has a long list of uses off-label.

Bipolar Disorder

The evidence that anticonvulsant agents are useful for the treatment of bipolar disorders has led to preliminary studies of TOPAMAX. However, research evidence does not support the use of this drug, as a "mood stabilizer".

Topamax is ineffective in treating acute mania. The manufacturer conducted several studies in search of the effectiveness of medication for treating acute mania or mixed episodes in adults with bipolar disorder. These studies showed that the drug itself was not effective in treating symptoms of bipolar disorder.

However, some evidence based on small studies support the use of TOPAMAX in the depressive phase in bipolar disorder and as adjunctive treatment. The results of the label Open indicates that adjunctive topiramate was associated with a significant reduction of new manic and depressive episodes in patients not responding fully to the stabilizers mood (Lykouras L, Hatzimanolis J., Curr Med Res Opin. 2004 June) One of the advantages is that it causes most bipolar patients either lose weight or at least not win.

Weight Loss

Weight loss is a common side effect of TOPAMAX. Generally not considered a good choice for weight loss due to the high rate of side effects such as cognitive impairment, anxiety, memory loss or difficulty in concentration, which may make it difficult tolerate the medication.

Several high quality studies have shown strong potential to reduce the weight of TOPAMAX. A randomized, double-blind, placebo-controlled that assessed the long-term efficacy and safety of this drug in obese patients. Topiramate in the course of 1 year resulted in weight loss clinically significant. In addition, improvements were also observed in blood pressure and glucose tolerance. (Wilding J, Van Gaal L, Rissanen A., Int J Obes Relat Metab Disord. November 2004)

Nerve pain

Antiepileptic drugs are useful in the treatment of neuropathic pain. There is good theoretical explanation of how topiramate may alleviate neuropathic pain. It acts on neuronal transmission in at least five ways: modulation voltage sodium ion channels, thereby enhancing inhibition of gamma-aminobutyric acid, blocking excitatory glutamate neurotransmission, modulating voltage of calcium-dependent ion channels, and by inhibiting carbonic anhydrase.

In the randomized, double-blind Topamax reduced the pain scale visual analogue worst pain intensity and sleep disorders in patients with painful diabetic neuropathy.

Yury Bayarski is a contributing author of eMedExpert.com. There are a number of other Topamax off-label uses, supported by a research evidence. More facts and comparison to other medications are available on author’s website.

Depression: Lifting the Dark Veil