Topiramate’s an interesting drug, but can also be quite the handful. I knew it was useful for migraine prophylaxis, but as a 2nd line for binge eating disorder? That was news to me! What does carbonic anhydrase have to do with this and the kidney stones? Is Zonisamide the same in this regard? What’s up with the brain fog or cognitive impairment patients describe with Topiramate? These and more in the video!
Periodic section yeah carbonic anhydrase maintaining elect uh it’s part of the electrolytic homeostasis they’re sure blah blah blah but there are other isoforms of the carbonic anhydrase enzyme you know some of them might even be found in sweat glands but this one there is a particular isoform of carbonic anhydrase that can be found doing its stuff with regards
To lipid metabolism and because of that this may explain why the pyramid and xenosamide lead to weight loss and this weight loss is being used utilized for its use in bench eating disorder but it’s not just the weight loss that seems to be its effects in fact a pyramid particularly we can more confidently uh the pyramid particularly we can more confidently
Say the pyramid can actually reduce binge episodes so if ssris are not cutting it you might actually consider the pyramid for binge eating disorder right um but another issue um with papira mate particularly brain fog brain fog that might be um one possibility so this is mainly speculation is because it is also a gaba a positive allosteric modulator not like a
Benzo but it still binds to gaba a and enhances the action of gaba on the receptor and particularly you have a subunit there right alpha phi subunit responsible for cognition particularly it can lead to anterograde amnesia so that might be one thing i don’t know if the nmda receptor action is involved in the glutamate receptors but a lot of people do complain
About you know difficulties with attention executive function memory concentration when on top you’re made so you really got to warn about this also connecting again to the mechanism yes carbonic and hydrogen inhibition is responsible for the weight loss but it is also responsible for the nephrolithiasis that can lead to formation of calcium phosphate stones
And so because of that you’ll want to when people are taking this drug you want to remind them to stay hydrated stay hydrated and to reduce the risk of kidney stones plus diet so probably that’s something you can talk to a nephrologist for or there are certain food strengths that can actually reduce the risk of these stones and some they can heighten the risk so
This amide generally it’s less preferred than the pyramid tapir meat that’s probably the reason why the pyramid is in the pnf encenasamite isn’t um the pyramid is generally prefer if you if you have to choose between the two just pick papaya meat um zunismith is less tolerated basically so similar properties but you need somebody’s less tolerated so yeah but in
Terms of spectrum they do cover a lot in terms of epilepsy both focal and generalized so at least you know you have options and this is my um commission artwork to help remember the pyramids and uh tamirama it’s mainly properties the kidney stones the table is again because of its inhibition of kidney carbonic anhydrase so rather remind them to stay hydrated the
Question marks there are well they’re having difficulty concentrating studying the munchlax here because of the brain fog and i made the munchlax slightly thinner um just slightly so that’s the weight loss so this is one way you can visualize the important properties of the pyramid right so this might see someone is anesthetized although i’m not sure how prominent
The brain fog is there the brain fog is really more prominent with the pyramid i hear yeah rafinha limited spectrum bit pricey one of them even has addiction potentials so they’re really far at the bottom of my list basically really far at the bottom
Transcribed from video
6 – On TOP (Topiramate) of the B.E.D. (Binge Eating Disorder) By Jetlax