Dr. Phelps,

I was diagnosed with bipolar II, in October 2006 after years of being told I was "just moody". In addition, I am a rapid cycler.  I was placed on 750mg of Depakote, 2 mg Klonapan, 50 Buspar, and 200 Zoloft.  As you can imagine, my weight sky rocketed.  I went from being a very physically healthy individual to an overweight slug who could not lift her head off the couch.  I was weaned off the other drugs and placed on Lamictal which has been a godsend.  However, topamax was added.  I started out at 100mg.  I have only been on it for 2 weeks, but my physician has taken me off it cold turkey because I was having severe side effects, so much that I could not leave my home.  Now, my question is this, what effect is this going to have on me? I have read the literature for epileptics stopping this medication without weaning, but nothing for an individual in my situation.  My physician says not to worry because it can't be any worse than what I have been through.  

Thanks so much,
Sam
 

Dear Sam

Although it is true that when we are stopping anti-seizure medications we generally try to taper them, this is not an absolute rule. For example, even lamotrigine sometimes has to be stopped suddenly for a skin problem you've probably heard about, and we do not worry about stopping it without any taper at all, under those circumstances.

So overall, in my experience, I would not expect much trouble from stopping the topiramate, nor any kinds of lasting effects. No guarantees, of course. But I hope that proves to be the case.

Dr. Phelps