Worrying Topa reaction; supervised Antabuse + mirtazapine + low-dose baclofen?

[Greg]

Hi all, sorry I haven't been around in ages, but I have been away without any proper Internet connection (which happens frequently). I hope everyone is well.

I have been trying baclofen plus topiramate/Topamax and found cravings possibly reduced, but also ran into a problem that has scared me off. I began having eye pain, although I may have just been noticing normal eye pains that normally attract my attention. I had read of an extremely rare eye problem with Topa, and now think I may have been over-reacting, but I'd rather try something else now.

I am sober at present and currently now getting my family to supervise me taking 100 mg of Antabuse each morning (1/2 a pill), so I can't weasel out of it and just stop taking it to drink again. This is the pattern I fell into over the past few months...taking Antabuse after quitting drinking but then planning to stop the pills and resume drinking. My addicted, cunning brain would make any and every excuse to do this, thus sabotaging any chance of recovery. Short periods of sobriety would be followed by longer periods of heavy drinking (15-20 standard drinks per night), so I was basically almost back to the mess I was in before I quit drinking in early 2010.

I read a post by Otter here somewhere that the antidepressant mirtazapine has been found to reduce alcohol cravings, and searches on PubMed seemed to confirm this. Otter also mentioned someone having used baclofen with mirtazapine, and finding they went from needing 150 mg or more of baclofen to only 60 mg per day with no cravings. I know this is only one case, but with the literature supporting mirtazapine's usefulness in at least some cases of alcohol dependence, plus my own sleep difficulties, this combination may be worth a try.

If it does help me, I'll report back about it.

[baclofan]

Worrying Topa reaction; supervised Antabuse + mirtazapine + low-dose baclofen?

Greg;1376490 wrote: I read a post by Otter here somewhere that the antidepressant mirtazapine has been found to reduce alcohol cravings, and searches on PubMed seemed to confirm this.

Hi Greg,

CTN Dissemination Library [no.898]: Mirtazapine in Comorbid Major Depression and Alcohol Dependence: An Open-Label Trial.

[Greg]

Worrying Topa reaction; supervised Antabuse + mirtazapine + low-dose baclofen?

baclofan;1376495 wrote: Hi Greg,

CTN Dissemination Library [no.898]: Mirtazapine in Comorbid Major Depression and Alcohol Dependence: An Open-Label Trial.

Thanks baclofan, that's a very impressive result. The employment improvement, in addition to the other areas of improvement, suggests real results rather than some of the more shadowy or marginal reports of results in many other medication trial reports. Given that I have a 25 year history of depression which began before I even drank to excess, this drug may suit me especially well. I will have to just put up with the initial 1-2 week daytime somnolence it has caused me during past trials, which was why I never stuck with it, but at least it should help my insomnia (which has likewise existed for 25 years or more, and is made worse when I stop heavy drinking, which is where I am currently at).

There are other reports of this...anyone can find them by looking up PubMed and typing in "mirtazapine alcohol dependence" in the search box.

[Greg]

Worrying Topa reaction; supervised Antabuse + mirtazapine + low-dose baclofen?

Please note that I have corrected my original post, and will be rewriting part of it on a more relevant thread.

[chaos]

Worrying Topa reaction; supervised Antabuse + mirtazapine + low-dose baclofen?

Re: Mirtazapine study: "drinking decreased from 33.9 to 13.3 drinks per week, a 60.8% decrease." That's heavy duty indeed!

[spacebebe01]

Worrying Topa reaction; supervised Antabuse + mirtazapine + low-dose baclofen?

Hi Greg

I also had high hopes for topa but had pain behind my eye, whether this was pain I have had before and ignored but noticed because of reading about the side effects of topa before taking it or actual side effect, or even an imagined pain I dont know, but Im not prepared to take a chance on my permanent eyesight to continue taking it, especially without a doctor as I bought it online.

I have taken Mirtazapine in the past, not sure how long ago but it was probably around 7 years. On it I did feel pretty well as I can remember, but had massive weight gain, which I have never managed to loose since stopping it, that was the only reason I stopped and after stopping it my drinking increased massively, that was when my problems really started with alcohol dependence. Before this I did have a problem with AL but after it became the 24/7 drinking and the hospital visits started. I have no clue what this means to anyone apart from myself and do consider going back on mirtazapine but couldnt cope with putting on any more weight from it.

[baclofan]

Worrying Topa reaction; supervised Antabuse + mirtazapine + low-dose baclofen?

The weight gain and unbelivable hunger...went away within 3-4 weeks, the dry mouth-lip SE is always there.

Ps, I'm such a guinea pig trying everything outthere...combining anticraving meds, switching between generic brands...in order to figure it out if they differ, and if so what way

Pss, I am such a hopeless case...therefore I've been called 'desperados'...

[Greg]

Worrying Topa reaction; supervised Antabuse + mirtazapine + low-dose baclofen?

Hi Space,

I too have really been wondering if I was just having ordinary pains on and off in the eyes, which I wouldn't normally notice but which I then did notice after having read of Topamax's very rare but serious eyesight risk. Like yourself I had ordered mine online, and didn't have a doctor to supervise me. Having to titrate up over many weeks also frustrated me, as my drinking was getting really bad, to the point of having pins and needles and pains in my hands and feet, then extending to the legs, arms, and body. These have thankfully gone away now, after massive doses of B vitamins and water, and then cessation of alcohol. These were definitely not imaginary, and could become permanent nerve damage if not quickly addressed.

As for the mirtazapine weight gain, I wish I knew an answer to that, as it seems a main complaint about the drug (along with excess daytime sedation), and the reason why some don't stay on it. Some, like baclofan, say it does go away after some time. The same problem exists for most people who have to take an antipsychotic these days, since the usual modern antipsychotics (Zyprexa and Seroquel) have some actions like mirtazapine (e.g. are strong antihistamines and block some serotonin receptors, both actions being suspected as causing weight gain).

Hey baclofan/desperados, all I can say is keep on trying anything and everything, which is what I have done over the years. I thought I was a hopeless case too, and at one point I was wandering around my small home town (where most people know one another) drinking at all times of the day as well as every night, and in the pubs and clubs day and night drinking and gambling. I no longer even cared about myself at one point, and carried a 700 mL bottle of vodka in broad daylight, drinking straight from it without giving a damn who saw me. It's a wonder the police didn't pick me up for that. Luckily I finally reduced it to night-only drinking, then had periods of sobriety, and have been on and off it ever since. All I can do is hope that this time will go better than previous times. If conventional medicine had treatments that worked well, none of us would have to experiment with various off-label treatments.

I have a couple of mates in real life who often seem to think they are hopeless too, and I can only hope they can try and get off the grog bit by bit if they can't do it all at once. One is trying baclofen from his doctor, but at a dose too low so far to know if it will help him. As long as someone hasn't totally given up trying, I don't think they are totally hopeless!

P.S. While I like this forum, jeez I wish it wouldn't log you off when you spend a bit of time composing a detailed reply!!

[baclofan]

Worrying Topa reaction; supervised Antabuse + mirtazapine + low-dose baclofen?

Thanks alot Greg!

[Greg]

Worrying Topa reaction; supervised Antabuse + mirtazapine + low-dose baclofen?

No worries. Also, just to clarify something...I have often said on here that I am only a night drinker, but the period of my life from about 1996 to 98 did include the day drinking I mentioned in my last post, and this included a few binges lasting 3-5 days during which a mate and I would return to the club every day to waste hundreds/thousands of dollars on both alcohol and poker machines (slot machines as they are known in the US). We would often be there from 10 AM to whatever time the place closed, usually 11 PM to 1 AM. I'm glad I am over that part of my life, if you could call it living! Untreated depression, rather than alcoholism itself, was the main reason I went so haywire.