[Tart Cherry Jam]

My pdoc suggests that my word retrieval problems are due to Topamax and not the Latuda/Thorazine combo I started on Aug 22. I thought he might be right as on Aug 10 I doubled the dose of Topamax from 45 to 90 mg a day. So to test his hypothesis, I went off Topamax entirely.

Knock on wood, no more word retrieval difficulties, at least none in the last couple of days. Given that Topamax is notorious for it and has even been dubbed Dopamax, I believe that was the culprit.

I took Topamax for appetite reduction, initially from April through early Aug at very little doses of under 15 mg and working up to 45 mg and did not have word retrieval difficulties at that time. So I will wait for a few more weeks to confirm it is indeed Topamax and then try reintroducing it at lower doses.

Has anyone had a dose-dependent word retrieval problem side effect on Topamax where you were able to tolerate small doses but not above?

[Soupe du jour]

I never took Topamax, but definitely heard and read about the issue you described with it. And its "Dopamax" nickname. I think other anticonvulsant moodstabilizers can have a similar side effect, although usually milder. I agree that dose can affect the severity. When I took higher doses of Lamictal I had cognitive dulling (including word retrieval difficulties) but at my lower dose it's barely an issue. I used to take quite high doses of Tegretol, too. Tegretol didn't affect me cognitively as much as with balance and similar issues. At my lower doses, even these side effects are minimal. They all usually have some effects beyond what they're meant to. High doses of Depakote gave me balance issues, too.

[unlived]

I’m on 100mg and noticed that after a while it got better. I still have problems with random words at random times but not very often. To start with it was a regular thing. I use it for migraines, appetite / weight and also to help with sleep so the occasional loss of words is worth it to me. But I know it can be bad!

[Tart Cherry Jam]

Originally Posted by unlived

I’m on 100mg and noticed that after a while it got better. I still have problems with random words at random times but not very often. To start with it was a regular thing. I use it for migraines, appetite / weight and also to help with sleep so the occasional loss of words is worth it to me. But I know it can be bad!

That is good to know, that it can get better!

I have just had a video visit with my medical weight loss specialist. She told me that at her clinic they do not prescribe Topamax in the presence of Latuda. She also increased my Ozempic to 1 mg to see if I can tolerate the higher dose.

I have checked interactions between Topamax and Latuda and it seems that they are more present in children and manifest in symptoms. So probably OK for me at my large body mass to continue with a tiny dose of Topamax, but I will hold off for now, hoping that Ozempic at a higher dose will be enough. If so, I will feel grateful to Topamax for giving me the initial appetite decrease which prompted weight loss before Ozempic kicked in.

[BeyondtheRainbow]

My experience with Topamax has been that it is a very picky drug when it comes to dosing. Small changes have been consequences for me. I've never gotten above 50 mg and I've had to go back down both times I've made it there because of GI issues. At 25 mg it helps me sleep and seems to work for some mood stabilization. I'm honestly not sure how much it helps now as I'm on a lot of Gabapentin but we're keeping it as is for now.

[unlived]

Originally Posted by Tart Cherry Jam

That is good to know, that it can get better!

I have just had a video visit with my medical weight loss specialist. She told me that at her clinic they do not prescribe Topamax in the presence of Latuda. She also increased my Ozempic to 1 mg to see if I can tolerate the higher dose.

I have checked interactions between Topamax and Latuda and it seems that they are more present in children and manifest in symptoms. So probably OK for me at my large body mass to continue with a tiny dose of Topamax, but I will hold off for now, hoping that Ozempic at a higher dose will be enough. If so, I will feel grateful to Topamax for giving me the initial appetite decrease which prompted weight loss before Ozempic kicked in.

The main issue with Topamax and Latuda is the same with any anti psychotic and topamax combined - the lack of sweating and over heating. It has a “major” interaction warning on drugs.com. I still took it with Seroquel but I had some not so good moments in summer. You really need to stay out of the heat and try and keep hydrated because your body can’t handle it properly.

[Tart Cherry Jam]

Originally Posted by unlived

The main issue with Topamax and Latuda is the same with any anti psychotic and topamax combined - the lack of sweating and over heating. It has a “major” interaction warning on drugs.com. I still took it with Seroquel but I had some not so good moments in summer. You really need to stay out of the heat and try and keep hydrated because your body can’t handle it properly.

I see. I did not notice anything, probably because I always super hydrate and stay out of the sun. Good to know.

I have been off of Topamax and the word retrieval problems seem to have lessened considerably.

[rjdb]

I'm on 100mg of it and have this exact issue, and just brain fog in general. Wondering if it's worth it. It does work for food cravings.

[*Beth*]

I haven't been on Topamax, but most of the psych meds I have taken cause cognitive impairment. I used to have a vocabulary I was proud of, I was excellent at spelling, and was articulate. (I never could do math, but that's another story, haha.)

Psych meds have sooo damaged my verbal and written skills. My ability to spell has declined badly. Word retrieval...not good. It makes me sad. Klonopin may be the primary culprit.

[Tart Cherry Jam]

Originally Posted by *Beth*

I haven't been on Topamax, but most of the psych meds I have taken cause cognitive impairment. I used to have a vocabulary I was proud of, I was excellent at spelling, and was articulate. (I never could do math, but that's another story, haha.)

Psych meds have sooo damaged my verbal and written skills. My ability to spell has declined badly. Word retrieval...not good. It makes me sad. Klonopin may be the primary culprit.

I feel for you, Beth! I have also apparently had a decline in IQ. I do not know if the meds, the underlying disease, or significant trauma I have been subjected to are the issue, but it is a problem for sure.

[unaluna]

Yeah i couldnt even play "Wheel of Fortume" at my max topamax dose! I am off it now.

[Mountaindewed]

I always thought my issue was just bad social skills due to not socializing for 2.5 years due to covid. I never thought it could be a med issue. My doctor put me on topamax about a year ago and then raised it to 150mil a day in the spring.

[unaluna]

Originally Posted by unaluna

Yeah i couldnt even play "Wheel of Fortume" at my max topamax dose! I am off it now.

Im not even a fan of the show, so it was pretty demoralizing

[Fuzzybear]

I haven't been on Topamax but most of the psych meds I've taken have caused some cognitive impairment. They tend not to tell us about this... I think most of the meds have effects beyond what they are supposed to do.