Topamax

[Squalus]

Question for the Doc's and anyone else who has dealt with this medication before or has first hand knowledge. A diver I know has been placed on this medication for management of severe headaches/migraines and is on a maintenance dose. They are a certified diver, but have not been diving since being placed on the medication for their diagnosis.

I have read up on the medication and uses, it is used for as well; Topomax is used in the adjunctive treatment of partial onset seizures in adults and pediatric patients ages 2 to 16 years, in Binge-eating disorder, and to treat bipolar disorder.
Add on treatment for primary generalized tonic-clonic seizures in adults and children, 2-16 years old.

Adverse effects:Anxiety, depression, sedation, speech problems, double vision, abnormalities in vision, decreased appetite, impaired cognition, memory impairment, dizziness, impaired muscular coordination, tingling in the extremities, an unsteady gait, nausea, respiratory infections, or weight loss.

Now this person wants to dive again, I have suggested that they contact a physcian or contact DAN to get cleared prior to diving again. I do not think that they will do what was asked.

What do you do, take their dive gear and escort them to a doctor against their wishes? Wait till we see it on the "Accident and Incident" thread? I do not, would not like to see that.

[PairofMedics]

Question for the Doc's and anyone else who has dealt with this medication before or has first hand knowledge. A diver I know has been placed on this medication for management of severe headaches/migraines and is on a maintenance dose. They are a certified diver, but have not been diving since being placed on the medication for their diagnosis.

I have read up on the medication and uses, it is used for as well; Topomax is used in the adjunctive treatment of partial onset seizures in adults and pediatric patients ages 2 to 16 years, in Binge-eating disorder, and to treat bipolar disorder.
Add on treatment for primary generalized tonic-clonic seizures in adults and children, 2-16 years old.

Adverse effects:Anxiety, depression, sedation, speech problems, double vision, abnormalities in vision, decreased appetite, impaired cognition, memory impairment, dizziness, impaired muscular coordination, tingling in the extremities, an unsteady gait, nausea, respiratory infections, or weight loss.

Now this person wants to dive again, I have suggested that they contact a physcian or contact DAN to get cleared prior to diving again. I do not think that they will do what was asked.

What do you do, take their dive gear and escort them to a doctor against their wishes? Wait till we see it on the "Accident and Incident" thread? I do not, would not like to see that.

O.K. Lemme see if I can help. I am acritical care paramedic and flight medic, and as it so happens I used to take this medication so I hope I can help. Topamax is a great medication that treats migraine headaches prophylacticly...before they start. The dosage is adjusted to how many breakthroughs occur...headaches that reoccur despite the medication. Some of it's side effects can be a bit unnerving...especially the ones regarding muscle coordination and tingling extremities. I am no longer on Topamax because as soon as I stopped drinking diet sodas 99% of my headaches went away, and the migraines I get now are very seldom and are easily treated with a nap and pain relievers. The big question is...how long has he been on the Topamax? The sketchy side effects usually take about 4-6 weeks to present at full dose...so if he's been on the drug longer than that he should be good to go....keeping in mind that the possiblility of their emergence later is still a possibility, although highly unlikely. Most medications in the blood are not affected by pressure or depth, unless in the system as a gas, which Topamax is definately not. I would still contact a doctor, preferably a neurologist who knows about this drug and how it could go sideways on you. As a side note, tell your buddy to take stock of any possible triggers for his headaches and eliminate or limit his exposure to them as much as possible. As it turns out there's a neurochemical in diet drinks called phenylalanine that was triggering my migraines. When I eliminated the diet drinks, the migraines went away. Anyway, I hope I helped, and if you need more, let me know.