Ok awhile back I was on lamictal and Topamax, both mood stabilizers. I have been on Lamictal for eight years and have slowly noticed cognitive issues, which have affected my work and school life, but when I added the Topamax it went downhill fast. I asked my pdoc what was going on. Hopefully I explain this right and understood him. Bipolar is like epilepsy, our brain is having tiny seizures all the time but without the physical effect. For that reason, our mood stabilizers, lamictal, are also used for epilepsy. I think they were originally used for epilepsy. These mood stabilizers slow things down, which is why we have these cognitive issues. I also believe the disease causes problems. I lost part of my photographic memory, I'm so slow at work. I'm still on the lamictal, I refuse to come off of that. Im on 400 mg. I ended up lowering my Topamax to almost nothing, I use it for weight loss because of my Seroquel, and I couldn't believe the improvement in my cognition. I didn't feel like a complete idiot anymore. Maybe this makes sense, it made sense to me when my pdoc explained it.