Q:  Can topamax alone keep my mood stable?   

Well, I have read & read & read some more & I still have a
question.  I always thought I had a major depression problem (it came and
went).  Then recently (well, 1999) my husband died & the grief plummeted me
into the worst depression yet.  I sought therapy when I self-diagnosed
myself. My pdoc now tells me I am bipolar, Type II. He had me on Wellbutrin,
Serzone and Topamax and Zyprexa. (All at the same time.) They kept me from
killing myself but I was in mostly zombie land...

Now, I am on Topamax alone; and it seems to be working.  I am no longer
clinically depressed, but I still lack any zest for life, am lazy beyond
belief; this is like living in a "blah snydrome world".  I can tolerate
this, but I am not happy with it. My FEAR is, can Topamax alone keep me
sorta on an even keel (albeit this keel is a rather dull one)?

Dear Ms. C.C. -- 
The answer is "maybe yes", as we don't have a lot of long term experience with Topomax yet.  Ask your doctor how much risk he thinks you'd take to try monotherapy (as you are now, just a single medication) with some other mood stabilizer, and whether in his opinion that one might also be able to keep you "on an even keel" -- which is a very apt way of thinking about what the medication is supposed to do.  The point is, if you really have bipolar II, there may be several different mood stabilizers that could work for you, and there is definitely a possibility that you could have even-keel without dulls-ville; however, there is some risk of losing the stability you now have while you're trying other options.  So it's tricky, but hopeful. 

Dr. Phelps

Published May, 2001