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Topamax plus Wellbutrin = no appetite
Posted: 03 November 2007 01:32 PM   [ Ignore ]   [ # 31 ]
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Larry Hobbs - 03 November 2007 05:36 PM

Juliana,

Regarding Topamax and hair loss.

Weight loss doctor Michael Anchors, MD, PhD, author of “Safer Than Phen-Fen”, wrote:

—————

Weight loss alone, if substantial and rapid, is well known to cause scalp hair loss. No need to blame Topamax specifically. Weight loss is not reported with it. No one taking Topamax for migraine or neuropathy suffers hair loss. The case is pretty clear.

The mechanism advanced for hair loss is interesting. It’s said that fat loss releases fat-stored androgenic hormones. Do you believe it? If so, then androgen blockers should alleviate the hair loss. There are expensive powerful ones, but an old, cheap, not-so-strong one young doctors won’t know is spironolactone.

Weight-loss associated hair loss is always limited and temporary, even without treatment, but my, how the women stress over it, often the same women who were less worried about the beauty effects of 100 lb of extra fat. Go figure.

Michael Anchors, MD, PhD


where to begin.

first of all, I hope you don’t trust his opinion for anything else based on this response.

how can he speak for everyone by saying

No one taking Topamax for migraine or neuropathy suffers hair loss. The case is pretty clear

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but my, how the women stress over it, often the same women who were less worried about the beauty effects of 100 lb of extra fat. Go figure.

that is one of the most insulting, condescending and chauvanistic statements I’ve read in a long long time.  He might be surprised to know that men experience hair loss with Topamax also.

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this is the one page I was talking about in my previous post where there are many many posts about hair loss

http://www.askapatient.com/viewrating.asp?drug=20505&name=TOPAMAX

 

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these are the results from just the first 2 pages of a google search on hair loss topamax - would anyone like more links or is this enough?  I also have a link somewhere to a message board where there are many many threads and posts about hair loss. 

 

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http://answers.google.com/answers/threadview?id=333816


http://www.migrainepage.com/dcforum/discussion/15515.html#1

http://www.medhelp.org/posts/show/23304


http://www.madebymark.com/madebymark/2003/02/topamax_the_pri.html

http://www.baldingblog.com/2006/02/20/topamax-low-ogestrel-and-female-hair-loss/

http://www.mentalhealthcare.org.uk/pharmacist/expanded/index.php?id=60

http://provillusshop.com/data-topamax_hair_loss_growth_how_long__a41a.html


http://my.epilepsy.com/?q=node/972344

http://www.epilepsyfoundation.org/efforums/forum/messageview.cfm?catid=4&threadid=54391&enterthread=y

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Posted: 04 November 2007 07:09 AM   [ Ignore ]   [ # 32 ]
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Juliana,

Regarding Topamax and hair loss.

Weight loss doctor Alan Terlinsky, MD wrote:

———————

Dear Larry,

I have not had a single case of hair loss on Topamax that was attributable to the Topamax as far as I can remember.

Topamax has been around for a very long time and now has an indication for migraine. Women far out number men for migraine which means there should be ample data to decide if this is a true side effect. I don’t think a medicine marketed to women would be in use very long if it casued hair loss.

The most common cause of hair loss in young women is hormonal in nature. Anecdotal reports like this never provide the whole story or clinical background. I would have liked to know the rest of the patient’s clinical background including any other medications or hormones these women may have been on.

Regards,

Alan Terlinsky MD

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Posted: 04 November 2007 07:26 AM   [ Ignore ]   [ # 33 ]
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Juliana,

Regarding Topamax and hair loss.

Weight loss doctor Robert Skversky, MD of Newport Beach, California, who, last year, was featured in both the Wall St. Journal and on the CBS Morning Show about “off-label drug use”, wrote:

————

Larry,

Admittedly I have seen hair loss which I believe is associated with Topamax but believe it to be very infrequent.

I believe hair loss is much more likely related to fairly rapid weight loss associated alteration in estrogen-androgen ratios and subsequent a form of “androgenic alopecia”. [Hair loss due to elevated testosterone levels.]

Some of these patients may also experience some acne, and the women may also notice irregular or missed menstrual cycles.

I use biotin and highest dose rogaine which I believe helps stop hair loss although minimally effective for regrowth.

Thyroid of course should be checked (tsh and free t3) and if needed Topamax can be stopped.

On occassion I will use a “hair growth” product similar to what a well known New York dermatologist, Norman Orentreich uses, which includes a combination of Rogaine, Retin-A [tretinoin gel], aldosterone, and a topical compounded solution of Propecia.

However, I do not used Propecia (or Avodart) for women.

Robert Skversky, MD

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Posted: 04 November 2007 07:30 AM   [ Ignore ]   [ # 34 ]
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Juliana,

Regarding Topamax and hair loss.

Weight loss doctor Monte Meldman, MD of Deerfield, Illinois wrote:

———-

I’ve never seen hair loss with Topamax, but I use small doses.

Monte Meldman, MD

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Posted: 04 November 2007 07:41 AM   [ Ignore ]   [ # 35 ]
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Juliana,

Regarding Topamax and hair loss.

Weight loss doctor Blackford Noland, MD of Salem, Virginia wrote:

———-

Weight loss, particularly rapid weight loss, has long been associated with hair loss.

Most likely the cause of these women’s hair loss is a condition called telogen effluvium, which is actually hair shedding and not specifically hair loss.

It can be seen with many stressful events, not all of them bad, such as pregnancy with all the hormone fluctuations.

It can occur with severe infections and even personal tragedies.

The good news is that this is “hair shedding,” not hair loss.

About 100 hairs are normally lost every day, but there is a new hair in the follicle that pushes the shedded hair out as it reaches the resting stage.

When telogen effluvium occurs, hair shedding accelerates as the resting stage accelerates.

But the reason the hair regrowth takes so long is that the new hair is way down in the follicle and it takes months to grow out.

In my experience I have not seen permanent hair loss.

With the weight loss is a change in the balance of calories between protein, fats and carbs.

Alopecia [hair loss] is listed in the PDR [Physician’s Desk Reference] as a side effect of Topamax.

But I wonder if this wasn’t telogen effluvium.

Topamax affects appetite and I doubt there is any direct affect of the drug on the hair follicle.

The women who were distressed by their hair loss seem to have lost a lot of weight and for that to happen caloric intake was affected, which I believe was the true culprit.

Therefore, it might take courage, but if Topamax actually helps to maintain a significant weight loss, then with stability of the diet and no further stress associated with weight loss, the drug could be useful long term-and while new hair is growing back.

“Food for thought!”

B. Noland, MD

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Posted: 04 November 2007 07:52 AM   [ Ignore ]   [ # 36 ]
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Juliana,

I agree with you regarding natural, whole desiccated Armour Thyroid vs Synthroid (synthetic T4 thyroid hormone).

The drug company that makes Synthroid (synthetic T4 thyroid hormone) convinced the medical community that T4 is preferable to taking natural, whole desiccated Armour Thyroid.

About 12 years ago, I saw a 30-minute program on thyroid on the now defunked “American Medical Television”.

The show featured three thyroid experts who all said, “It’s best to only take T4 and let the body convert it to T3.”

However, the doctors who I respect the most on this and who think for themselves on this, such as Dr. Jonathan Wright, MD and Dr. Ward Dean, MD, have said that they often find that patients do better and have fewer side effects when switching from Synthroid (synthetic T4) to natural, whole desiccated Armour Thyroid.

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Posted: 04 November 2007 07:55 AM   [ Ignore ]   [ # 37 ]
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Juliana,

Regarding natural, desiccated Armour Thyroid versus Synthroid (synthetic T4).

Dr. Jonathan Wright, MD has said that “Synthroid, or synthetic thyroid, has undesirable side effects in most people.”

Dr. Ward Dean, MD has said…

“Synthroid, the most commonly-prescribed hormone for hypothyroidism, contains only one fraction of thyroid hormone - T4.

“T4 is normally converted by the body into T3, the active form. I believe that many hypothyroid patients are unable to efficiently perform this conversion.

“Armour thyroid, on the other hand, is a desiccated preparation of porcine thyroid, containing all thyroid hormone factors - T2, T3, and T4.

“I have found that it is very difficult to provide adequate thyroid supplementation with Synthroid without causing patients to become thyrotoxic.

“On the other hand, most patients who switch from Synthroid to Armour thyroid, report that they feel much better with the Armour product.

“The dramatic improvements that many of my patients have achieved on thyroid therapy often appear miraculous.

“It is very gratifying to hear a patient who has suffered for decades express how their lives have been totally turned around by a few cents worth of thyroid.

“Unfortunately, most physicians have been bamboozled by the manufacturers of synthetic thyroid hormone (Synthroid) into thinking that the Armour thyroid product is an inferior, non-standardized drug. Nothing could be farther from the truth.

“In fact, a recent study confirmed the efficacy of the Armour product compared to synthroid.”

Dr. Ward Dean has also said…

“Treatment of subclinical hypothyroidism with thyroid hormone is very safe.
“There is little risk of excessive thyroid dosage if:
“(1) the patient feels well;
“(2) the temperature remains below 98.2;
“(3) the pulse is less than 75 beats per minute; and
“(4) the thyroid function tests remain normal.
“(Note that most hypothyroid patients feel best with sub-normal TSH levels).”

Because of Dr. Wright and Dr. Dean, I also believe that natural desiccated thyroid such as Armour Thyroid (T4 plus T3) is superior to Synthroid (T4 only).

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Posted: 04 November 2007 08:02 AM   [ Ignore ]   [ # 38 ]
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Juliana,

I edited out the last half sentence from Dr. Michael Anchors, MD, PhD.

I am sure he did not mean to insult anyone.

I apologize for him. Please forgive him.

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Posted: 24 November 2007 06:16 AM   [ Ignore ]   [ # 39 ]
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I was searching both wellbutrin and topamax combo and vitamin b12 injections and came across this site so figured I’d add my 2 cents.

I recently (about 5 months ago) starting getting b12 injections for pernicious anemia and have gained about 15 lbs.

I thought people lost weight on b12 so I was surprised?

BUT I started on the topamax and wellbutrin combo today because 4 years ago I weighed 225 lbs and maybe a month after taking the 2 pills together I realized I was losing weight very fast.

I started logging my weight at 202 lbs and NO LIE 60 days later I weighed 140 lbs.

After joining a gym (at 140) I eventually got down to 125 so lost 100 lbs.

I was originally taking the medicine for bipolar disorder and thought I was feeling better so stopped taking them about a year ago, but now realize I need them not only for emotional reasons, but physical as well.

I should add that I had absolutely no appetite and lived on a negative calorie diet (usually celery and lettuce) because I was trying to lose as much weight as possible once I realized how fast it was dropping.

My doctors were concerned and did bloodwork and found I was iron and potassium deficient so I added bananas and tuna to my diet and was fine.

Not saying I recommend what I did to anyone else, but I went from fat and hiding in my house (and a size 20) to a size 4 and a body that most would die for.

I’ve been taking those new Alli diet pills for about a month trying to drop the 15-20 lbs I’ve gained (not to mention I quit going to the gym about a year ago because my new job requires me to travel daily) and those pills only make me “pass” orange oil (and I don’t even eat high fat meals). UGH!

I hope the wellbutrin and topamax works again.

I worked too hard the past four years at the gym (5 days a week) to keep this weight off to just keep this flab on and not fight to get it back off.

Anyone else taking the wellbutrin and topamax AND getting vit. b12 for pernicous anemia and NOT losing weight because of it?

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Posted: 25 November 2007 10:18 AM   [ Ignore ]   [ # 40 ]
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Im1968,

Congratulations on losing 60 pounds in 60 days, and 85 pounds in 90 days, and ultimately 100 pounds.

That’s incredible.

———-

Regarding B12 and weight gain…

A B12 deficiency or pernicious anemia can cause weight loss.

For example, one paper notes that “Complications of vitamin B12 deficiency [range] from lethargy and weight loss to dementia.”

See the abstract in PubMed here:

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=12650116&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

———

This means that correcting a B12 deficiency could normalize your body weight.

For most people, that is those without pernicious anemia, B12 injections will not cause weight gain… or weight loss for that matter.

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Posted: 25 November 2007 10:53 AM   [ Ignore ]   [ # 41 ]
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Thanks! I was always thin, just gained alot of weight from 2 pregnancies 15 months apart.

I read vitamin B12 is what breaks down the proteins, carbs and fats properly so now that I am getting the shots my body is functioning the way it is supposed to and I am gaining weight the way I should (before I ate whatever I wanted, not alot of food, but the wrong foods).

I also notice that the week and a half after I get a b12 shot I am so hungry (and eat non-stop) and seem to gain a couple of pounds but the week and a half before a shot is due my hunger subsides and my weight goes down.

(For the last 2 months) I give myself the shots and have decided to stop because I don’t want to gain the extra weight.

Do you have any suggestions for this? My doctor was having me inject 1000mcg a month but I’m wondering if it would be better to break it down and do weekly injections instead? My close friends think it’s in my head, but I know my body!

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Posted: 25 November 2007 03:47 PM   [ Ignore ]   [ # 42 ]
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Im1968,

I agree with you. It’s in your body, not your head.

I don’t know why this would be.

I’ll email some doctors and ask them if they have ever heard of this.

I don’t know if giving smaller weekly injections would be better or not.

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Posted: 08 December 2007 09:13 AM   [ Ignore ]   [ # 43 ]
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lm1968 - 24 November 2007 12:16 PM

I was searching both wellbutrin and topamax combo and vitamin b12 injections and came across this site so figured I’d add my 2 cents.

I recently (about 5 months ago) starting getting b12 injections for pernicious anemia and have gained about 15 lbs.

I thought people lost weight on b12 so I was surprised?

BUT I started on the topamax and wellbutrin combo today because 4 years ago I weighed 225 lbs and maybe a month after taking the 2 pills together I realized I was losing weight very fast.

I started logging my weight at 202 lbs and NO LIE 60 days later I weighed 140 lbs.

After joining a gym (at 140) I eventually got down to 125 so lost 100 lbs. .............

Congrats on your weight loss.
What dosages of Wellbutrin and Topamax were you on.  Did you start lower and go to highter doses?  (Titrate up?)
Also when did you stop taking the meds (if you did)?
I haven’t heard of B12 causing weight gain, other than a slight gain for increase in blood volume perhaps. ...?
Did you get any headaches on the Wellbutrin/Topamax combo too?

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Posted: 08 December 2007 10:01 AM   [ Ignore ]   [ # 44 ]
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I honestly don’t remember what I started on with the Wellbutrin, but the Topomax I was up to 400mg a day (200mg in the morning, 200mg at night).  The Wellbutrin was 300mg once in the morning.  I think I remember taking 50mg at one point, whether it was 50 total, or 50 in the morning and 50 at night, I’m not sure.  My doctor told me at one point to double up if I wanted to lose even more weight (which is when I increased to the 400mg a day).  He was a very insensitive psychiatrist I had when my PD of 8 years moved to another state (I eventually found another which I love).  I started taking the combo again on my own a few weeks ago because of the weight gain (which I am blaming on the vit.b12???) and have been splitting the 200mg Topomax taking 1/2 in morning and 1/2 at night, and taking the 300mg wellbutrin in the morning.  I have lost about 17 lbs since I started.  I cut all carbs out of my diet (absolutely no breads, rice, pasta, anything like that).  Only proteins, egg whites, tuna, salad, soups, turkey burgers, etc.  I’ve been eating 3 meals (yogurt, oatmeal, so I guess some starchy stuff) and I did give myself 1/4 of the b12 shot last week just to see if I would still lose weight (the doctors wanted me to give myself monthly of 1000mcg, but I only did 250 and might try weekly).  I hate diagnosing myself and trying to play doctor, but I have been diagnosed with fibromyalgia for 6 years now (taken out of work, put on pain pills, did nothing but lay on the couch/bed for years) and once I weaned myself off them darn pills ON MY OWN because I knew those pills were tricking my body and head I felt fine and went back to work on my own.  I think pain pills lower your metabolism and make it harder for you to lose weight.  Sorry to ramble.  I hope I answered your question and didn’t go overboard, lol.  I just heard something on tv the other day and I’ve been thinking of it everytime I get the urge to eat something non-healthy “NOTHING TASTES AS GOOD AS FEELING THIN FEELS”—good point, huh?

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Posted: 08 December 2007 10:07 AM   [ Ignore ]   [ # 45 ]
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I stopped taking them about a year ago because I was working out at the gym alot (5 days a week) and just didn’t feel the medication was doing anything for me anymore (at the time I was only using them for weight loss and not what I was supposed to be using it for - bipolar/borderline personality disorder).  It’s been about a year and I’ve been feeling pretty depressed, not myself, not to mention the last 5 months or so put some weight which I’m blaming on the vit.b12 (could be wrong of course).  I just figured the topomax and wellbutrin kills two birds with one stone, manages my depression and anxiety and controls my weight so I might as well give it a try.  I see my doctor next Tuesday so I’m looking forward to seeing what he has to say. I have a history of eating disorders, and those meds are not usually recommended, so who knows what will happen.

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