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    Skeptical Doctor

    This is my first posting. I read the book and postponed starting until after spring break with my family. I met today with my doctor who at first seemed ok with the program. He had not heard of Topiramate being prescribed for treatment of acoholism, but mentioned he was familiar with recent prescriptions for weight loss.

    He was concerned with side effects, particularly reduction of sodium levels. I pointed out that the program had nutritional supplements to help offset side effects. I showed him the pages of the book that addressed the dosage regimine of supplements and Topiramate. He became alarmed at the dosage levels of Topiramate peaking at 300 mg. He checked his reference and said maximum dosage suggested was 150 mg. in extreme cases. I pointed out the study in The Lancet and provided a copy to him. He stated that what I provided him was an abstract and that he needed to source the complete article in the hospital library.

    He was unwilling to prescribe at the levels indicated and stated that he would be willing to refer me to a psychologist who may be more familiar and more willing to write the prescription. I mentioned that I had some concern of a medical record of referal and treatment for alcoholism as I had seen the question asked on life insurance applications. He understood my concern and stated that job applications may also ask that. I asked if he were to prescribe topo for this purpose would that also leave record of treatment for alcoholism, and he said it would as he was required to state the reason for prescribing the medication. This is a concern of mine as record of treatment may cause inability to get insurance or employment. I know medical records are confidential but waivers are common on applications allowing access to those files.

    He suggested AA as it is anonymous and has a proven track record. He also stated that my desire to moderate drinking was likely unrealistic and that complete abstinence was the only reliable solution. He did agree to look further into this and consult his peers regarding this use of the medication and the dosage levels. I dont know how long this may take.

    I had planned to let my wife know of my decision after meeting with the doctor. She is an RN and is concerned about how much I drink, although I consume more than she is aware of. I am disappointed and wonder if I should try the program without medication as others have, or find another doctor. I would appreciate some input.

    #2
    Skeptical Doctor

    Hi Bilbo,
    I too have a skeptical doc. She perscribed Wellbutrin for me - seems to think my drinking problem stems from depression and unresolved emotional issues.
    She did perscribe Wellbutrin as an anti-smoking aid so depression will not be on my record. Also an insurance problem.
    I have been doing MWO for more than a month without the topomax and I am fine. Yes, I have cravings, but not insurmountable.
    Moderation is my goal as well, but I have been abstinent for the past 2 weeks. My drink of choice is beer and I have some no-alcohol beer on hand to "fool myself". It actually works.
    Hopes this helps you a little. I'm sure you will get other responses and a lot has been discussed re: topomax and doctors. You can sort through the threads a bit there.
    Welcome, Bilbo.
    I wish you success.
    Helen

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      #3
      Skeptical Doctor

      My doctor used migraines as a ICD9 diagnosis code for the insurance companies and medical records. She agreed to leave the alcohol issues out of it. She asked me to get my sodium bicarbonate levels checked twice so far. Initially her jaw dropped at the the mention of 300 mg in the Lancet article that I brought to our first meeting.I am not up to that dosage after almost 4 months by the way. She really liked the exercise and self hypnosis...... and . She also really liked the results!!!!

      She was furthermore very encouraged by last months American Family physician article citing topamax as an effective treatment for this problem. Dont give up, I cant even tell you what a godsend it is. Even if its only a stepping stone to quitting for good. It has given me some distance, or breathing room from that painful repetitive behavior,.......and even though I have enjoyed moderation for these 4 months ....... now I see that alcohol isnt all its cracked up to be, it holds no special power or magic and now I can take it or leave it most of the time.

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        #4
        Skeptical Doctor

        Wow Vida,
        I can't get topa here, but you really remind me why I should try. The whole thing is such a long term battle.. and it's when I hear that it's "NOT a battle anymore" once on topa.. makes it seem pretty important.
        (1) Can get it offshore or (2) can plead migrane to get script.
        Working on it,
        MFM

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          #5
          Skeptical Doctor

          Hi Martian!

          I'd certainly try to plead migraine! My sister gets them--horrible headaches with puking, yuck! Maybe read up on the symptoms first so that you can describe them really well! Only problem is that they might try to rx you something else: Let's think of a game plan!

          I think your plan to lobby to the topa is a good one, and all the things that you are already doing to get started is a wonderful beginning toward that goal!

          Hugs,
          Kathy

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            #6
            Skeptical Doctor

            My Doc absolutely refused Topa and referred me to look at the possible side effects. I looked them up on WEBMD.com under medicines , Topamax ans side effects.
            Everyone should be aware of the possible side effects, just to know what to look for.

            Still made 3 days with supps and All-One which is great because I have no appetite at all !

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