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Pharmacy/Migraine Medication

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Question
Hello,

I have been taking gabapentin (1800mg/day) for about 3 month, and topomax (200mg/day for about 2 months. I am wondering if you can tell me whether the side effects of anger and anxiety are very pronounced and long term. I have these symptoms (anger, irritability, and anxiety) to begin with. They seemed to be worse when I started the medications, but this seemed more tied to being very tired. However, now things are more leveled off and I am trying to find if these medications might still be provoking these symptoms, or if they'd be more noticeable if it was the medicines.

Second, I am wondering about memory,brain fog, concentration, etc. Does this tend to subside with time? Is it only for small things, like misplacing things for misspelling words? Or if I, for example, take it for 2 years, will my entire memory of my kids growing up be foggy?

Last, I know Topamax can cause vision issues. I have noticed some blurred vision in my left eye. But, I didn't pay any attention before I started taking it. Is this the kind of vision side effect Topomax can cause, or again - would it be more pronounced?

Thank you so much for your time and information.

Answer
Hi,

 The side effects of anger and anxiety may or may not be pronounced and/or long term.  If you are taking gabapentin 1800mg/day, are you taking 600mg three times a day? Perhaps your doctor
can give you different doses to take at different times to help combat fatigue during the day.  

The memory, brain fog, concentration may or may not subside with time.  I am not sure how permanent or temporary it is.  If your Topamax is causing blurred vision, please tell your physician immediately.  He or she may choose to stop the medication.  Are you getting both medications from the same physician? These medications are both anticonvulsants; I am not sure if you need to be on both at the same time.  Perhaps the MD can switch you to an antidepressant instead.  

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Nanaz Khosrowshahi

Expertise

Being a pharmacist, I can answer questions on medications. This includes how drugs work in the body, drug interactions, drug side effects, warnings and precautions to take when using certain medications, dosage forms and strengths, management of overdosing, storage of medications, drug administration, contraindications, and drug indications. I am able to guide them on lab work that needs to be drawn and monitored while on certain medications. I am able to help patients save money when purchasing medications by directing them to cost-effective therapies. I am able to answer questions on federal laws governing pharmacy practice in the United States. I am unable to answer questions legally as if I am diagnosing the patient's disease or illness. For example, if a patient stated he had upper flank pain, I am unable to say he definitely has a urinary tract infection. However, I am able to direct the patient to the correct next step, which is to call his physician with such a side effect.

Experience

I have been a licensed pharmacist since 2007, holding licenses in CT and MA. I have a PHARM.D from an accelerated pharmacy school program. Currently, I work at the Hebrew Home and Hospital in West Hartford, CT as a pharmacist. I am a well-rounded pharmacist, with experience in long-term care, IV home infusion, retail, hospital, and hospice. I serve as the pharmacy unit coordinator for Mass Dispensing Area #31 in CT, where I am called upon as a volunteer pharmacist in case of public emergencies, such as anthrax threats. I helped run the swine flu vaccine clinic in 2009. I am on the Editorial Advisory Board for Pharmacy Today, a publication of the American Pharmacists Association. My position on the board runs for three years. Every month I make suggestions and offer ideas that would help improve the magazine. I have undergone extra training to administer vaccines to patients, which is training that only a certain percentage of registered pharmacists in the country have.

Organizations
American Pharmacists Association 2007

Education/Credentials
Massachusetts College of Pharmacy and Health Sciences, Worcester, MA- PHARM.D 2007 University of California, Irvine- BA psychology 2001 cum laude

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