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        New Message Board Archives >> Medications, Treatments, Therapies 2004 >> topamax - estrogen - memory
        
(Message started by: CJohnson on May 13^th, 2004, 11:46am)

Title: topamax - estrogen - memory
Post by CJohnson on May 13^th, 2004, 11:46am

Reduced estrogen has been linked to memory and other cognitive problems. Topamax has been shown to lower the estrogen levels of birth control pills.
I haven't seen anything that demonstrates the effect topamax has on regular estrogen levels for persons not on birth control, but it is enough to leave me wondering if there is some kind of connection between topamax affected estrogen levels and cognitive issues some people experience while on topamax.

PFDANs
-Curtis

Title: Re: topamax - estrogen - memory
Post by floridian on May 13^th, 2004, 2:24pm

Topiramate does speed up the breakdown of sex steroids. The research was done in conjunction with oral contraceptives, but the mechanism (activation of cytochrome enzymes) would lower steroids from natural sources as well. It could explain some cognitive changes.

Quote:

Clin Pharmacokinet. 2000 Apr;38(4):355-65.
Pharmacokinetic drug interactions between oral contraceptives and second-generation anticonvulsants.

Wilbur K, Ensom MH.

Drug interactions between oral contraceptives (OCs) and traditional anticonvulsants have been well described. However, in the past decade, a number of new anticonvulsants have been developed, as well as modifications made in the composition of the OC preparations themselves. Additionally, anticonvulsants are increasingly employed in the therapy of nonseizure-related disorders, placing more women at risk of potential drug interactions that may lead to contraceptive failure. Second-generation anticonvulsants include felbamate, gabapentin, lamotrigine, oxcarbazepine, tiagabine, topiramate, vigabatrin and zonisamide. Most have been approved for adjunctive management of seizures refractory to therapy with traditional anticonvulsants. On the basis of available study data in women receiving concomitant OC preparations, gabapentin, lamotrigine, tiagabine and vigabatrin may be administered without significant pharmacokinetic interactions that potentially diminish contraceptive efficacy. However, additional or alternative contraceptive measures, including using OCs with higher estrogen content, are recommended when using felbamate, oxcarbazepine and topiramate, as these agents have demonstrated enzyme-inducing activity leading to reduced plasma steroid concentrations. The effects of zonisamide in women receiving OCs have yet to be reported. It is important to characterise the properties [e.g. substrate and enzyme activity (particularly cytochrome P450 3A4 induction)] of new anticonvulsants and recognise their potential to interfere with OCs. However, a pharmacokinetic interaction does not in itself indicate loss of OC efficacy. Contraceptive failure should be measured by changes in ovarian hormone concentrations, maturation of ovarian follicle(s) or ovulation.

My wife's grandmother had breast cancer. The therapy included some radical anti-estrogen measures. She developed alzheimers almost immediately (or more likely, the anti-estrogen therapy brought the Alzheimers to the surface).

Title: Re: topamax - estrogen - memory
Post by Edski_1 on May 13^th, 2004, 3:33pm

Interesting. Floridian, would you think that extending this to the male end of the spectrum is too much a leap? If topiramate interferes with sex hormones would that potentially lead to a decrease in sex drive while on "el Dopa"?

Not sure I paid any attention to that durring my 3 months on the stuff...but I had little motivations to do much of anything, so I would guess my interest in nookie was depressed.

Title: Re: topamax - estrogen - memory
Post by floridian on May 14^th, 2004, 1:53pm

Found an analysis of topomax side effects at:
http://www.rxlist.com/cgi/generic2/topiram_ad.htm

Forgetfulness and spacyness seem to be definite problems compared to placebo (but affect less than 10% of those taking Topomax), while decreased libido was only reported in 2 cases out of 181 or so, and was only slightly above the placebo rate.

Not sure how reliable those numbers are - from what research I did on Paxil (an SSRI), I concluded that alot of side effects like decreased libido or the 'zaps' were under reported. When someone has clusters or depression, how does one separate side effects from medicines from symptoms of the disease? It can be done, but isn't always easy. Taking a med can cause side effects, living with untreated clusters has side effects, having so few people with clusters means we don't have enough solid research.

Title: Re: topamax - estrogen - memory
Post by MarkV on May 14^th, 2004, 10:21pm

hah

Ed said nookie.

sorry, couldn't resist.

Beavis & Butthead fan. ;;D

Have a good weekend,

MarkV