Be Very Careful!!!!!!!with Topamax

[JackDanielsGirl]

I was taking topamax and pristiq, and a little over a month ago i was found at home in a comatose state. I stayed that way for 24 hours and was intubated by EMS when my family could not wake me up. The MD said it was serotonin syndrome, Topamax and Pristiq or any SSRI (antidepressant), should never be taken togeather. Please warn people you know that are taking these two meds togeather. The nurse taking care of me in the ICU also had this it is rare but very possible. Hers was caught before it got to the point mine did. The symptons are apearing drunk, when not drinking, electrolyte imbalance (my potassium was dangerously low), forgetfullness, weakness. Please be ware this was the most scareiest thing I have ever been through.

[sunshinedaisies]

Be Very Careful!!!!!!!with Topamax

Thanks for the heads up Jackdanielsgirl - I took Celexa and Topa for years and fortunately never had any trouble but it isn't something that my doctor ever mentioned...... I am off the Celexa now - but that must have been so scary for you - so happy you are okay.......

Hugs, Sun X

[JackDanielsGirl]

Be Very Careful!!!!!!!with Topamax

Thats the problem most doctors are not aware, i was prescribed these meds my regular doctor and when i went through detox the MD there (A CD MD) represcribed them. Thanks for the well wishes.

[Kradle123]

Be Very Careful!!!!!!!with Topamax

Hi JD
I am on .50 topa and lamictal a bipolar med. My doc is not thrilled with the the combo more for liver damage reasons. I have not nor has he he ever told me about such a severe SE...This is is RARE you say?

What does of Topa were you on and for how long? also may I ask if you were still drinking at the time if the incident. I apologize for personal questions but lately the Topa is creating many neg. SE for me: terrible forgetfulness , almost drunk like feelings... But I don't have those awful huge cravings....so

I am literally caught between the Devil and the Deep Blue Sea....
Thanks for your post and please feel free to PM me though I am still getting used to figuring how that all works. :l

[Kradle123]

Be Very Careful!!!!!!!with Topamax

Oh and my Doc is a psycopharmacologist so hits speciality is all these psychotropic drugs but still there is no substitute for first hand stories and experience ...
I wilL of course be calling him tomorrow

[JackDanielsGirl]

Be Very Careful!!!!!!!with Topamax

Kradle 123
I was on 50mg of Pristiq daily and Topamax 25mg bid (twice a day), i drank some but not anything like i was beforfe, my blood alcohol when i entered the hospital was .10 which in our state the legal limit is .08. This is a rare condition, but aftter what i went through i am trying to warn everyone. It is very frightning to lay down for a nap and wake up 24 hours later with a breathing tube in. Like i said in my earlier post my nurse (of which i am also) had a lighter occurance of the same thing. It appears from my research it only happens when you take a SSRI and topamax; however there are some OTC meds that can cause this too such as anything with DM. Hope this helps If you have any other questions i will be checking this thread frequently.

[Kradle123]

Be Very Careful!!!!!!!with Topamax

Thanks JD
I am very appreciative !
:l

[baclofan]

Be Very Careful!!!!!!!with Topamax

Actually my Doctor prescribing Topamax encouraged me to to take it with cipralex (escitalopram/lexapro) reasoning that topa is often not effective med for depressive states but it's pretty good for mania/hypomania (in my case dysphoric mania)uch:. BTW he suspects me of having a mild form of bipolar, I'm starting to believe that he placed right diagnosis.

JDG, that may or may not be relevant but pristiq actually is classified as an SNRI so is somewhat different from a typical SSRI because impacts not just serotonin but also another neurotransmitter called norepirephrine.

[JackDanielsGirl]

Be Very Careful!!!!!!!with Topamax

thanks baclofan, i am just going on the admitting MD diagnosis. He said that was the only explantion he knew; but there is no way to test for this it is just a process of elimination, with symptons present. Welcome any other info.

[Bruunhilde]

Be Very Careful!!!!!!!with Topamax

Thanks JDG, your warning makes me wonder - I was thinking about starting up again with the topa, but last time it made me freak out. One morning I was crying on the phone with my poor parents, panicking about my life and my finances. Normally I would only do that drunk and not with my parents.

This time I'm also on baclofen and gabapentin and hypertensives. Will that help or also be a bad combination? The bac helps with my anxiety and I'm currently on about 40mg/day. The gabapentin helps with my panic/depression, and is indespensible sometimes esp during PMS.

Any advice is welcome. Thanks for your warning!

[JackDanielsGirl]

Be Very Careful!!!!!!!with Topamax

Bruunhilde

You are welcome, I just dont want anyone else to go through what I did.

I am not sure about using the combo with other drugs I am only familiar with what I was taking, I do know gabapentin (Neurontin, correct?) is used for neurological pain, i was not aware that they used it for panic/depression. I would advise to consult an online pharmacy like WebMd.com or your local pharmacy. At this point I am still afraid to even an asprin. You can research Serotonin Syndrome on the internet.

[Greg]

Be Very Careful!!!!!!!with Topamax

I would never have guessed that Topamax and Pristiq could have resulted in serotonin syndrome, as Topamax isn't mentioned as having any serotonin effects in most literature. Also this drug combination was not warned about in two drug interaction checkers (online) when I typed the two names in. I supposed it goes to show that unexpected interactions can occur in some people but not in others, or else medical authorities don't know all the combinations that can produce serotonin syndrome.

Anyway glad you're ok now.

[Greg]

Be Very Careful!!!!!!!with Topamax

It seems as if a variety of medications can sometimes interact with SSRIs (and presumably SNRIs) to contribute to serotonin syndrome. The following abstract mentions topiramate as one of numerous drugs that can play a part in this...it's apparently due to topiramate altering an enzyme function:

Serotonin toxicity: a short review of the literat... [Neurol Sci. 2011] - PubMed - NCBI

[Bruunhilde]

Be Very Careful!!!!!!!with Topamax

Thx all. Was thinking JDG if you took any supplements like tryotophan or 5_htp? Just trying to figure it out.

[spacebebe01]

Be Very Careful!!!!!!!with Topamax

Ive also never heard that topamax has any effect on seretonin. As Bruun says there are quite a few over the counter suppliments that, when combined with an SSRI can cause serotonin syndrome. I think St Johns Wort can stay in the system a couple of months, tho Im not totally certain about that. One thing I am certain about tho is just because you can buy something in a health food shop doesnt mean its compleatly harmless, especially when combining it with ssri.