Has anyone been prescribed Topamax purely as a sleep aid?

I have been on various psychiatric medication for two decades, including most of the drugs that you mention. Unfortunately, I have no personal experience with Topamax, though I have close friends who take it. I have never, ever heard of it being used as a sleep aid. I don't wish to throw a wrench into the works of a possibly otherwise-functioning doctor/patient relationship, but many people do not know that the quality of psychiatric doctors varies widely. Extremely widely. Prescribing psychiatric medication is an art as well as a science, and not every doctor has mastered both aspects. Since you are relying on your doctor's knowledge and judgement, you may not recognize that you have an incompetent doctor until suddenly you notice they're not listening to you, or they're advocating something off-the-wall, like Topamax for sleep. In my opinion, that's a totally bizarre recommendation. I have been on a medication that gave me symptoms like you experienced on the Seroquel. It was an absolute horror show, and people tend not to believe how bad it is unless they've experienced it, or they think you're just complaining about your weight. (I'm not sure if weight has been an issue for you, but it has been for me.) Most of the drugs commonly prescribed for depression/bipolar/etc are associated with long-term weight gain. Topamax is often prescribed as a counter-measure because it is one of the few safe medications with decreased appetite as a side effect. So I wonder if your doctor is hearing "eating issues" and responding with "Topamax!" even though you are asking about sleep. Psych meds usually cause serious insomnia, unless your medications happen to be sedating, which most of them are not. Many doctors underestimate the importance of sleep. If you aren't sleeping, you are never going to feel good. It's very, very basic. Doctors do not have a great selection of sleep meds at their disposal right now. Ambien's reputation has been going down the toilet recently and some doctors are afraid to prescribe it, even if that's the only one that works and you have taken it before with no problem. You have a right to sleep at night. Some doctors will try to give you crappy half-measures around the sleep issue because they're afraid to pull out the big guns, but you deserve to have this solved. Ambien is a fine drug if you do not have the side effects. Many people take it with no problem, myself included. Your profile says you are in one of the major cities on the East Coast. I have had the best luck with doctors who are as high up the food chain as I can find, preferably associated with a respected teaching hospital, and who strike me as caring and informed. Disclaimer: I am not a doctor or mental health professional. I am a patient who has been around the block a few times. These are my observations and opinions.

and by "rotate" I, of course, meant "titrate" I blame both the auto-correct and my inability to notice it until the edit window closed. This was not a topomax error, but it's a good example of what it can feel like on "dopamax".

The good news is that my primary care doc did send in a referral for me to get an overnight sleep study in a lab. Yay! That was easier than I thought. The bad news is that it's going to be a bit of a wait, but that's to be expected since it's non-urgent. Meanwhile, I am taking the lowest Topamax dose and taking it with my Lamictal in the evening, not the morning, and that is helping somewhat. Thankfully, the "Dopamax" effects haven't taken hold except for a few incidents. I still worry that I got myself put on some kind of drug seeker blacklist with my pdoc, and I am not sure how to bring that up. Thanks for all your help!

So you don't have to wait a week- I have experience with east coast Kaiser, sleep tests, and many of the meds discussed above! (I tried topomax for headaches, and it removed all appeal from eating and turned my anxiety up to 11, so not great for sleep for me.) I did the take-home sleep test after many months of exhaustion and non-restorative sleep. The test was negative for apnea but I was referred to a sleep specialist within Kaiser, who suspected I had apnea anyway. He authorized an overnight study in a sleep lab, followed by an all-day study (MSLT), for which my co-pay was $50 per test, $100 overall. The authorization was very quick, but sleep labs in my city have long waits, so it was 6 weeks between authorization and the actual overnight study. In the end, the overnight didn't reveal apnea or any other physical reason for excessive daytime sleepiness. The sleeping pills I've tried were overly sedative or didn't give me energy the next day, and my bpII doesn't play well with stimulants (e.g. provigil). I've had success with acupuncture, which I was very reluctant to try, and I only did after exhausting western medicine options. Good luck!

Patheral: I hadn't thought of it that way; maybe I will give the Topamax another chance after all. I wish my pdoc had said that the Topamax was for my bipolar and not just for sleep, though; he said nothing about it helping my bipolar (for which I'm on Lamictal, and that is an enormous help - one of the key meds that keeps my brain cooties at bay). And, FWIW, it was my shrink - a Psy.D - who diagnosed my bipolar and helped get me on the correct cocktail for my particular brain cooties. If my shrink weren't on a long vacation, I'd be going to him with this problem as I'm sure he'd be of more help. My next question on the green will probably be about sleep labs! Thanks again to all who answered. You helped a lot.

I doubt you'll be viewed as a drug seeker unless you have a history of drug abuse. I don't have a drug abuse history and I push pretty hard about sleep. I have just spent too many nights sitting up until 6 AM and I refuse to accept it anymore. I view it as a quality of life issue. When I was looking for a new doctor, I tried several different ones. I was just upfront about the reasons I didn't want to see the previous doctors again and nobody ever raised an eyebrow about it. Your mileage may vary on all of this. I'm just giving my perspective as someone who's been a psych patient for a long time and experienced some similar issues. It's hell, I know. Good luck out there.

Not really answering your question directly, just some anec-data, but http://en.wikipedia.org/wiki/Mirtazapine knocked me out in about 30 minutes for the first month or two. I also had very intense dreams, which may not be your cup of tea. After about 2 months, the sedative effect wore off, but I still have intense dreams (which is generally a good thing for me). Crazy Meds http://www.crazymeds.us/pmwiki/pmwiki.php/Meds/Remeron seems pretty accurate.

Okay, I have bipolar too. I've been on Topamax for roughly seven years. I'm gonna guess here and say that you weren't prescribed it strictly as a sleep aid but to calm your racing thoughts so you can sleep. The Dopamax side effects disappear after a while. Give it time. Topamax is the ONLY medicine that's worked for my mania. The. Only. One. And I've been on the med-go-round for many, many years. I'm actually on both Topamax and Seroquel (as well as Welbutrin) and that cocktail has really been a mind-saver for me. Anyway, I just wanted to suggest that you might look at Topamax as, not a sleep aid, but another ingredient in your crazymed cocktail.

Gentian: I am actually on the West Coast. I am insured through an HMO, which is great when it works but for mental issues - not so much. I'm going to find out just how much it will cost me to go to an out-of-network sleep lab, and then, if I can afford it, get a sleep test. I worry that trying to be a good advocate for my sleep will translate as "drug seeking." As it is, I wonder if I did something that inadvertently set off my doc's druggie-dar because he was perfectly happy to keep renewing my Ambien prescription for years, until I told him that it wasn't working so well anymore. And I have taken Lunesta before, prescribed by my oncologist. As it stands, I don't think my primary care doc will give me anything without going through my p-doc first - when I told her about my horrible weight gain and cravings from the Seroquel, she just referred me to him. I don't know if there is another psychiatrist in my HMO accepting new patients and who isn't an hour's drive away. And if I change doctors, it just might get me slapped with the dread "doctor-shopping drug-seeker" label. So. I'm going to try and get a sleep study and give the "sleep without prescription meds" a month or two. Then, if the sleep study doesn't help and nothing else helps, I'll go back to my doc and see if I can get something that WORKS (in my case Ambien or Lunesta). My current doc has actually been pretty decent and worked well with me until recently when he for some reason has decided that Ambien and Lunesta are EVIL and now has seemingly gone off the deep end with exotic sleep meds. I'm also going to ask around on the Crazymeds site to see what they might think. Thanks everyone for your input - it was very helpful!