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Q: When should Topamax be considered as a mood stabilizer and at what dose?
MITCHELL RUBIN, MD
NORTH VANCOUVER, B.C.
A: Topamax (topiramate) is an anticonvulsant currently being studied for possible use in bipolar disorder. Previously, anticonvulsants such as valproic acid (Depakene) and carbamazepine (Tegretol) have also been used.
At the moment, Topamax has limited evidence and therefore should not be a first-line mood stabilizer for bipolar disorder. It should be well down on the list of treatment...