Any rapid Topamax titrators on here?

[Greg]

I am very seriously considering Topamax + low-medium dose baclofen + Antabuse as my new strategy against alcohol dependence, probably along with the antidepressant mianserin, as this is the only antidepressant that has ever helped me (and believe me I have tried them all except MAOIs).

My decision is due to recent advances in combination medication therapy for alcoholism, as I recently outlined in another thread. My hope is for near-complete elimination of alcohol cravings, but without needing high doses of baclofen or having to rely on cannabis and benzos as I formerly did. My aim is complete and permanent abstinence from alcohol, given the hell it has caused me over 22-23 years.

As I currently understand it, topiramate/Topamax is supposed to be titrated very slowly up to effective doses, so that it would take 5 weeks to get up to the 300 mg/day dose that was used in alcoholism trials done by Professor Bankole A. Johnson.

Has anyone here successfully increased Topamax at a faster rate? Please note that I am not suggesting that anyone do such a thing, as there are very good reasons for the dosage guidelines set out for anticonvulsants. But I am curious if anyone managed to get away with doing this. My alcohol cravings have come back with a vengeance lately, and I am desperate to do something to RAPIDLY combat them, out of fear that I might throw the towel in once again and deliberately stop taking Antabuse if the obsession with alcohol starts getting the better of me.

Another idea, which I will try over the next couple of days, is the use of the Pacific Island plant preparation kava kava as a direct alcohol substitute. Although kava has been largely banned as an import into Australia (for ridiculous, politically-correct reasons), there remains one brand of kava pills that are legal here, although 10-15 at one time would be needed to simulate the social kava-drinking practices of Fiji, Vanuatu, etc.

Anyway, sorry for the rambling. I'm just interested to know if anyone has titrated Topa up quicker than 5 weeks. An alternative combo could be pregabalin/gabapentin + baclofen + Antabuse + the antidepressant, since pregabalin and gabapentin can be increased to maximum dose a lot faster than topiramate.

If I have any success with any of these approaches, I will post about it on the forum. Best wishes to everyone here in our fight against alcohol dependence.

[sunshinedaisies]

Any rapid Topamax titrators on here?

Greg - you can titrate up faster with Topa than the recommended way - in fact you can go straight to 300mg if you wish - however, it won't do you any good. I have been on Topa for some time. I did get to the 300mg which for me is my level that it takes!! for a lot of people, they reach the level where AL becomes undesirable earlier - unfortunately for me I had to get to 300mg. then I stopped taking it, started drinking again and had to start all over again - to try to keep this relatively short - I have started again on Topa a number of times. through experience, I KNOW that jumping in at higher levels does no good at all. You HAVE to titrate up at the suggested doses. It isn't 'cos of SE's or whatever - it is something to do with the way the body takes it up I think. All I know is that when I have tried going in at a higher level, it was a waste of time - I always had to go back down to the 25 and start all over again. I know you want this NOW but trust me - slow and steady wins the race. I have just this past week got to the 300mg level again and again,. the Topa has just kicked in for me...... I also have started taking L-Glut and the kudzu from here religiously and between the three - Topa, and the fomer two m,entioned, it all works - I poured a drink last night and three hours later, it was still sitting there - albeit with a few mouthfuls taken, but I just couldn't drink it. my head wanted to but my body didn't!! It was awesome to wake up this morning at 5.00 feeling totally unhungover!! please feel free to PM me if you want/need any more info...... Good luck with this.....

Hugs, sun X

[windycitylady]

Any rapid Topamax titrators on here?

Greg, I've never taken topa, but my cravings were almost completely eliminated with 1200 mg gabapentin and 40 mg bac. I say "were" because they've crept back in a little, but I think some of that is situational. I am thinking of increasing the bac slightly. I do also use canabis nightly. I find that it gives me "something to look forward to." I know you're trying to get away from canabis, I just mention it in the interest of full disclosure.
If you remember, my kava experiment was strange. It made me feel a little drunk and a little like I had taken cocaine. But instead of acting as a substitute, it just made me crave alcohol and cocaine. I don't say this to discourage you. In fact, I'd be interested for you to try it and see what happens. It's my understanding that doing a large amount of the pills does work as long as they're of high quality. I feel bad because I have probably half of a pound of pure powdered root sitting in my kitchen that I don't intend on using. Too bad.

[playland]

Any rapid Topamax titrators on here?

Hi, I would agree with Sun, start the Topa low and titrate up slowly and let it be assimilated into your bloodstream. This is not a fast acting drug, the level has to build up slowly and be maintained consistently over time to be effective. I have not taken gabapentin at a high dose so I have never noticed that it helped my alcohol cravings, I have taken it for chronic pain and it has been quite helpful for that. Anyway, I'll be waiting to hear how it goes for you, lots of luck.

[wanttobesober]

Any rapid Topamax titrators on here?

Hi Greg,

My post is not related to Topamax, as I have never tried it, but I wanted to ask you a question
for a while about your depression so I might as well ask it here.
Have you tried large dose of Niacin for depression?

Andrew W. Saul has a clip on Youtube that says it is very effective.

http://www.youtube.com/watch?v=7K2tqxKf2EE[/video]]Natural Treatment for Depression Explained - Naicin B3 - Food Matters - YouTube

He also have some other recipes on his website: Doctor Yourself:

depression

Good Luck!

Brian

[Greg]

Any rapid Topamax titrators on here?

Thanks everyone for the replies. If I do take the Topamax route, I'll just be patient and let it build up over the proper time. I guess after 22+ years of drinking, I can wait another 5 weeks or so.

L-glutamine and kudzu are options I should give a go too, as there is nothing to lose, and some definitely seem to find them helpful.

The professor who is working on this latest anticonvulsant+baclofen idea does indeed mention gabapentin, and also the similar pregabalin. He may well use gabapentin plus baclofen for some of his patients, and I will keep it in mind in case Topa doesn't work out.

I would still prefer cannabis over alcohol any day, if I had to use something. I have to give it credit for helping me stay AF for those 19 months, and for other shorter AF periods. Many people would say I wasn't truly sober due to the cannabis use, and that I was substituting one addiction for another, but at least it doesn't have alcohol's massive destructive power. I still hope to keep away from it now, but in moderation (e.g. just at night, rather than smoking constantly like real stoners do) it seems less damaging than alcohol.

I did try kava years ago, when it was still legal to import into Australia, and it did simulate alcohol in some of its actions. Luckily I didn't seem to get cravings for alcohol or other substances due to the kava either. I will be trying 10-15 pills this time, which gives around the amount of kavalactones that would be consumed by Pacific Islanders during an average kava session. I'll let you all know if it helps or not.

I have been taking a general vitamin B supplement that contains 150 mg per pill of the nicotinamide form of B3. Not sure if this helps depression the same as if it were niacin, but I think the pills do help to some degree. I'll look further into this topic.

[Ghostwriter]

Any rapid Topamax titrators on here?

Sunny is absolutely right. I went from a liter of vodka a day to a glass of wine a night with the recommended schedule of Topamax (up to 100mg). Started drinking again and then, six months later, started again at 100 mg and it was useless. On the advice of Sunny, I started again at 25, upped it to 50 last week and it's starting to work again. I'm determined to stay off vodka and I find I'm able to do that, and without much craving even for wine, etc. Good luck!

[Greg]

Any rapid Topamax titrators on here?

I'm glad to hear this Ghostwriter. My drinking is up around the 15-20 standard drinks per night whenever I relapse, so I'm pretty hardcore...was also at 20/night every day for years before 2010.
Do you mind me asking, do you guys take 25 mg per day for one week, then 50 mg per day the second week, and so on up to 100 mg? If so, do you take it all as a single dose? I have seen a different recommended titration schedule for Topamax, which starts people on 25 mg twice per day, but that is the epilepsy guideline, not for drinking problems.
Sorry I know it's probably on one of the old threads here, but I have had trouble finding it.

[baclofan]

Any rapid Topamax titrators on here?

Hi Greg,

Do you mind me asking, do you guys take 25 mg per day for one week, then 50 mg per day the second week, and so on up to 100 mg? If so, do you take it all as a single dose?

That was my exact titration schedule. When I reached 75mg I started taking it all as a single dose just before bed time, it helped to eliminate SE. Mind you topa has fairly long (over 20 hrs) half life.

[Greg]

Any rapid Topamax titrators on here?

baclofan;1328419 wrote: Hi Greg,



That was my exact titration schedule. When I reached 75mg I started taking it all as a single dose just before bed time, it helped to eliminate SE. Mind you topa has fairly long (over 20 hrs) half life.

Thanks, this is how I will take it too. Just waiting on my doctor to get back to me about it at the moment. I imagine taking it all at night would reduce daytime sedation, among other things.

[Kradle123]

Any rapid Topamax titrators on here?

Hi Greg:
I second and thrid Sun & Ghost:

4 years ago went with the MWO titrate schedule to the letter. Did Great. Stopped at 100mg was great and then stopped alltogether. Went back to drinking....
6 months ago tried to jump back in even at the modest level of .50. Awful No effect at all and had the worst Vertigo ever. So now I am back to the bitter begining...
.25 for 2 weeks and now I am at .50 which actually may be too fast as I feel more ditsy/hungover and bitchy than ever. But the cravings are a wee bit better.
I am going to take my .25 in the eveing now and then again at bed time. See hoe that goes.
i am 5 9 and about 140 pound, in good shape. I'm sure Hieght/weight affecys our dose

I am also on Lamictal for Bi-Polar which has been magnifiscent for me. Saved my life and a few other people's I'm sure

:lHope this helps

[Greg]

Any rapid Topamax titrators on here?

Thanks Kradle, I am going to make sure I take it gradually, and also not stop taking it, as everyone says you have to go right back to the beginning for it to work again.

I have also been interested in Lamictal, since I suffer from depression and almost no antidepressants have ever helped. One did, mianserin, which is Tolvon/Lumin, so I am trying that again now. If it doesn't help this time, I will ask about Lamictal, since apparently it can help some depressed people even if they are not bipolar (which is my case).

[Greg]

Any rapid Topamax titrators on here?

P.S. I may give gabapentin a try before topiramate actually, since it can be titrated up quickly, and has fewer side effects. It all depends on what my doctor tells me when he finally hears back from another doctor running an alcohol treatment program...the other doctor is using either gabapentin or topiramate with baclofen from what I can gather.

[Trixiebelle]

Any rapid Topamax titrators on here?

I'm waiting on my supply of Topa via Goldpharma, so find this thread very interesting.

May I ask at the risk of sounding very ignorant - why did some of you guys, (Kradle and I think Sun) suddenly stop taking the Topa?

Is it because you thought you didn't need it anymore or were you experimenting?

I havent really read anywhere where it says you stop taking it, so I'm interested to hear if it has to be taken forever or for a while.

[sunshinedaisies]

Any rapid Topamax titrators on here?

HI there Trixie - I stopped taking it ages ago (but have since started again) after 8 months AF. I need to get to 300mg for it to work for me. Although oddly enough this time, on reaching 300mg, the cravings, although really greatly lessened, have not gone away. The reason I stopped it the time I was AF, wasn't because I thought I could do without it - but because at the 300mg, it seemed to plunge me into a deep depression and although I wasn't drinking, I wasn't happy. I stopped the Topa, stayed AF for a while, then broke my foot - I was home bored and thought I might just have one Guinness - seeing as how I had stopped thought I would be able to mod. BIG joke. Within two weeks I was back up to my nightly Guinness. So, I started all over again.... Apart from then I have never gone off it - just have gone back to the 25mg when I have really messed up on dosage and feel that to get the benefit of it I needed to start again......

As for having to take it forever - that is something I don't know. I don't have any SE's - that I know of. i forget words sometimes but put that down to age - LOL. I shall take it as it comes re stopping it. My doc left and I have a new one who isn't as pliable as my old one so I might not have a choice one day......

Sun