it is nice to see someone else who measures depression by being suicidal...lol....I remember crying through a pdoc appt and him asking me if I was depressed and I kept saying no because I wasn't suicidal. he thought I was out of my mind. I know meds were the answer for me, the right meds...and it took a lot of experimentation to find them. and like you said, the Topamax doesn't seem to be doing it so it doesn't make sense to raise the dose. I didn't let pdocs do that, or drag out for months. if I didn't see results in the first couple months I was off it and on to the next one. luckily I found the right AD fairly quickly. wellbutrin did it for me. it didn't trigger a mania. Zoloft triggered the worse one of my life. it was frustrating to try so many meds but well worth it as I have been living a "normal" life for years now. haven't been depressed for five years now and off the AD. only took it for two years. it just took patience. and a patient pdoc. take care.