Anticonvulsant

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• QWhat are the side effects of valproic acid in people with dementia?

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  A Dr. Sarah N. Mourra, MD , Neurology, answered on behalf of UCLA Health

  The side effects or adverse effects from valproic acid (Depakote) in people with dementia involve rash, bleeding risk, dizziness and confusion, which can occur when levels become toxic. For this reason, blood levels of this medication should be frequently monitored to make sure that they are not reaching toxicity. With older adults, doctors tend to keep Depakote levels at the lower range, as long as it is working for the behavior. Doctors follow the behavior, not the drug level.
   
  It’s important to know that sedation can occur with Depakote, as well as changes in liver enzymes, which the doctor will frequently monitor. In rare cases, Depakote can affect liver function, and that in itself can cause confusion and other issues somewhere down the line. If your older adult is experiencing new-onset confusion and Depakote has been recently started, bring this to the attention of the doctor sooner rather than later.
• QWill insurance cover Neurontin?

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  A Dr. Elif E. Oker, MD , Medical Toxicology, answered

  Whether a health insurance plan covers a particular medication depends on a number of factors. One key factor is whether the medication is FDA (Food and Drug Administration). In addition to FDA approval, insurance companies will consider research and best practice guidelines in making coverage decisions. Each plan is different, so it is best to check with your own plan to determine whether a medication is covered or not.

• QCan I take Neurontin with other medicines?

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  A MDLIVE answered

  Yes, but check with your doctor or pharmacist on possible interactions. Generally, neurontin won't seriously interact with most common medications but this risk increases with increasing dose of Neurontin and your medical conditions, especially kidney disease.
• QAre there any risks in taking Topamax (topiramate)?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Risks in taking Topamax (topiramate) include experiencing side effects, such as blurred or double vision, drowsiness, dizziness and trouble thinking or speaking. Until you know how you react to the drug, it is best not to drive or operate heavy machinery while using it. Sometimes Topamax makes you stop sweating, which can raise your body temperature, making you more likely to become overheated, dizzy, faint or succumb to heat stroke. This drug can also cause mood swings or behavior changes, which can lead to depression, agitation, irritability and suicidal thoughts or actions. You and your family should be vigilant about watching for any disturbing mental changes. Developing kidney stones is an additional risk of taking Topamax. Drinking six to eight glasses of water each day may help prevent this. If your child takes this drug, it may slow growth.Your child may also develop hyperammonemic encephalopathy, which is a serious condition. If your child experiences odd drowsiness, lethargy, dullness, sluggishness, anxiety or depression, unusual or vivid dreams and nightmares, or vomiting, call your doctor immediately. Use of this drug may amplify the effects of alcohol or central nervous system depressants, such as sleep and pain medicines and antihistamines used for colds, hay fever, and allergies, by making you drowsier and less alert. On the other hand, birth control drugs that contain estrogen may become less effective while you are on this medication.
  
  
• QHow does Topamax (topiramate) treat Lennox-Gastaut syndrome?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Topamax is used as a treatment to help reduce the seizures caused by Lennox-Gastaut syndrome. It is not known exactly what chemical reaction or suppressive action causes Topamax to work. Seizures happen because of irregular signals firing in the brain, causing spasms and other symptoms. It is thought that Topamax works by stopping these rapid, irregular signals from firing in the brain.
  
  
• QWhat are the side effects of Topamax (topiramate)?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  Topamax may cause side effects. Serious side effects include: inability to concentrate and problems with memory, impaired speech and imbalance, a tingling feeling or loss of sensation and weight loss. You might feel eye pain, your eyes may become red or your vision may be blurry. You might become confused or feel nervous. Other serious side effects include: sudden blindness or severe eye pain; serious confusion accompanied by dry mouth; elevated body temperature, skin dryness and thirst; muscle aches or seizures accompanied by vomiting; rapid heart rate; fainting; increased urine output or trouble when you urinate; serious pain in your lower back or side. If you experience any of these symptoms, call your doctor right away.

  If you begin to have facial swelling, hives or breathing trouble after taking Topamax, call 911, as you're likely experiencing an allergic reaction. If you experience dramatic mood changes in general or begin feeling depressed, anxious, nervous, aggressive, hyperactive or suicidal, these are serious side effects and your doctor should be notified immediately. Less serious side effects include: feeling tired, headaches, dizzy or difficulty sleeping. If these become bothersome, call your doctor.
  
  

• QWhat happens if I miss a dose of Topamax (topiramate)?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  If you miss your regular dose of Topamax (topiramate), take it as soon as possible. However, if it is nearly time for your next dose (within six hours), then don't try to make up the missed dose and return to your regular dosing schedule. Never take a double dose to compensate for a missed one, as overdoses can cause severe side effects.
  
  
• QHow does Topamax (topiramate) treat epileptic seizures?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  It is not known exactly what chemical reaction or suppressive action causes Topamax to work. Epileptic seizures happen because of irregular signals firing in the brain, causing spasms and other symptoms. It is thought that Topamax works by stopping these rapid, irregular signals from firing in the brain.
  
  

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• QWhat should I avoid while taking Topamax (topiramate)?

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  A Stacy Wiegman, PharmD , Pharmacy, answered

  While taking Topamax (topiramate), avoid starting a diet or weight loss program without talking to your doctor first. Avoid the Atkins diet or any similar low carbohydrate or high fat diet while on this medicine. Avoid ketogenic diets (low carbohydrate, high fat diets), which are sometimes prescribed to control seizures. Also be aware that there have been dispensing errors noted for Topamax and a drug called Toprol-XL. It is suspected this may be due to similar names, proximity in shelf location in pharmacies (when stored alphabetically) and similar strength options. If you receive a medication that looks different from what you are used to receiving, check with your pharmacist to be sure the correct medication was dispensed and check all accompanying paperwork carefully.