Hi, I'm on Lamictal now but am having breakthroughs. Pdoc suggested going back to Lithium but I'm afraid of the weight gain. I suggested that I would like to try a smaller dose of Lithium (900mg instead of 1200) with a dose of Topamax. Hoping the Topamax will offset the Lithium weight gain and also assist the Lithium in bringing down my mania states. The doctor says she's not comfortable with Topamax. It hasn't been FDA approved for BP and she has never heard of anyone using this cocktail.

Anyone out there using this cocktail? thanks, k--

hey,

I am on Lithium, Topamax, and Lamictal(along with 2 other psych meds) :eek: . I do see where you are at, but I don't quite know where you are with the weight issue. I am looking at d/c my Lithium because of weight gain(with pdoc's permission , of course). The Lamictal in combination with Topamax and one of my antipsychotics has really "leveled" my moods/paranoia/overall agitation, and kept my weight down. The doc says d/c Lithium would help with my weight loss.(I had gained a mountain of weight from Zyprexa). I don't think Topamax has been approved for treatment of BP, but it is a mystery to me why it works-I had some short term memory probs with it, but it might not affect you the same way it did for me.

Topamax has been used with lithium and in other drug combinations for Bipolar for ages. In fact for Bipolar it isn't very effective alone and is generally combined with
other medications.
Unfortunately, as far as weight loss, it's a crap shoot: some people gain weight some don't.

I was at one point on Lithium and Topomax together (along with prozac and abilify). I had a really bad experience with it. Both lithium and topomax make you groggy and kind of make your mind move slower so when they combined the two I was a mess. I kept falling asleep in my classes, couldn't remember anything, couldn't even speak clearly. I ended up getting in a really bad car accident becuase my thinking was so slowed that I shouldn't have been driving at all. At that point I went off of both the lithium and the topomax and I felt a lot better and could think more clearly.