Hi Dr.

I have no psychiatric dx. I am a 64 y.o. type II diabetic taking insulin, avandia, and starlix along with zocor, neurontin (300), synthroid and vitamins.  I continue to gain weight and I cannot sleep. My nights are crazy as I sleep for about one hour and then I am up for 3-4 hours before I can get another hour of sleep.  My question is:

Would Topomax help me with weight loss and sleep? Thank you.

Len

Dear Len -- 
I'm afraid it would be inappropriate of me to guess without knowing more than you can really tell me in this setting.  As you may have gathered from what I've said about Topomax to others here, and on my own site, I am very cautious with it because of its effects on one's ability to think straight, and on balance -- two things that we generally get even more cautious about when people get older (like, over 55, for example).  So on that basis I think I'd probably avoid Topamax for someone in your circumstance, and almost certainly would if you didn't have a fairly obvious bipolar variation.  Take a look at the thyroid story, though. 

Dr. Phelps


Published September, 2001