Sunday, May 9, 2010


I titled my head back and dumped four tiny pills into my mouth from a small paper cup. It was the first time in years I’d taken a drug.

I was taking Topiramate—a drug commonly used to treat epilepsy in children—because I was participating in a genetics and memory study here at Duke. And they were going to pay me $100 for 45 minutes of “work.”

I should first note that I’m staunchly opposed to taking pharmaceuticals of any sort. I’ve never taken an antidepressant, I can’t remember the last time I took an antibiotic, and it’s been years since I’ve even had something as mild as aspirin. I like to think of each illness as an opportunity for my immune system to get stronger. Plus, it just seems like a bad precedent to set to swallow little powdery discs cooked up in a lab to cure our every ailment, big and small.

So of course I was reluctant to take Topiramate, even for $100. But I decided to sign up for the study because I knew I was going to be cash-strapped next year since I recently elected to be unemployed this summer (a subject I’ll discuss in a forthcoming post).

I’m not sure what they intended to learn from the study. I had taken memory tests last year and they wanted me to take the same tests again this year, except on Topiramate, perhaps in order to gauge the cognitive ramifications of the drug.

They said that they give placebos to some subjects, but if I got the real thing I could expect to feel temporary side effects like numbness in my hands and feet, confusion, and memory loss. They told me to come back an hour and a half later when the drug will have kicked in.

I took a nap on a couch outside the office in between sessions. I woke up and my feet were asleep. I was confused: were my feet asleep because of the Topiramate or were they asleep because of the funny way I had to fold myself onto the tiny couch? And, was I legitimately confused or was I just confused because of the Topiramate?

They took a sampling of my blood and a grad student asked me a series of questions that tested my memory. Beforehand, she asked me how much I thought the drug was affecting me. I said I still wasn’t sure if I felt any of the side effects. The truth was that I was slightly nauseous and dizzy, yet I was wary that they gave me a placebo and my mind was merely playing tricks on me. I certainly didn't want to be one of those people who pathetically imagine that they've been infected with the latest disease-of-the-week because they heard about it on the news the night before.

A grad student--who administered the test--read me several short stories that went something like: “The children went to the zoo. They saw a gorilla. The gorilla reached through the bars and grabbed the teacher.” I was to immediately repeat the story to her but when I got to “the children” my mind became enveloped in a fog and I could hardly recall anything more.

She timed me as I traced a line with a pencil from the numbers 1-10 spread out on a sheet of paper—a task I performed with my tongue protruding from the side of my mouth and my hand making slow, halting movements like a kindergartner tracing a letter for the first time. In the next exercise she asked me to tell her all the words I could think of that start with the letter “R” in a period of 30 seconds. After a ten second pause, I swiveled my pinky in the hollow of my ear and said “rancor”—a word I’ve never once used in actual conversation.

“Maybe you did give me something,” I admitted.

After another 20 minutes of testing she handed over the $100 and I asked her how long the side effects would last.

“Twelve to twenty-four hours.”

I was in such a reduced state of mind that I failed to appreciate what this meant. In three hours I had a dinner engagement with one of my professors.

We were going to meet up at a Latin American restaurant. I got there early and splashed some cold water on my face in the bathroom. I felt drunk except that I wasn’t jolly, witty, or relaxed—the good attributes inebriation sometimes affords me. Instead, I was slightly off-kilter, dizzy, and some of my inhibitions had lifted.

I began the conversation by saying, “Professor, I’m only 70 percent here just so you know.”

I then told the tale of my afternoon. I was two sentences in when I realized that I could barely piece together a string of words, let alone a story. But that didn’t stop me from trying. I tried to compensate for quality with quantity. I told him how I wanted to hop freighters and live in the woods naked for a couple months. While there is some truth to these stories, without the ability to explain their philosophical underpinnings they just came across as the ramblings of a mad man. My professor nodded, maintaining a curious half smile throughout the meal.

As dinner wore on, while he spoke my head would occasionally loll off to the side or my eyes would train in on some bright object behind him for an inordinate amount of time. On our way out of the restaurant we shook hands and he said with a guffaw, “You really got to get off the drugs. Maybe take a nap or something.”

He said it good humouredly, but earnestly. Maybe I was “more gone” than I thought I was. I suddenly felt far more self-conscious of my state. He had a look of hopeless concern in his eyes—the sort of look a professor might give to a once-promising-student-now-turned-junkie who he happens upon sprawled out in an opium den, eyes half-lidded, face-jaundiced, with a trio of large flies living off the crumbs that the student is too lazy to sweep off his chin.

I wanted to take his advice and sober up. A nap would do me some good I thought. The van was way too hot so I went to the library where I knew there’d be some couches. It was packed with people studying for finals but there was one seat left.

I plopped down and instantaneously dozed off into a deep, troubled sleep. I don’t remember what I dreamed, but I woke up on three occasions and muttered to myself, that was so fucked up. All I could remember was running, screaming, lightning and quicksand. When I woke the third time, not only were my camo-colored boxers liberally exposed but people were eyeing me from all corners of the room. They seemed content to get a look at my face before continuing on with their work. I’ve been known to scream in my sleep every now and then, and something tells me I gave them a show.

The nap did little to alleviate the symptoms. My head reeling, I thought of the $100 in my pocket and how I'm ready to never take another drug again.


Anonymous said...

Yikes. You would think they would at least tell you upfront that the side effects would last that long and offer a place for you to "dry" out. But I guess once they are done with you and have gotten their information they no long care what happens.

Do you plan on going to the professor and doing a better job of explaining things?

~~Mike~~ said...

I might have paid a $100 to watch that whole scene unfold! :)

97 Roadtrek 170P "Taj Ma Trek"

VJP said...

I'm sorry for your experience, but thank you for being a guinea pig for a day. You don't know how that drug might beneficial [although it sounds more like a weapon to me].
I remember about 10+ years ago, they were paying $500 for colonoscopy studies, which seemed crazy at the time, but many lives have been saved since then.

Next time, try the dental school--I was in 2 benign studies for tooth whitening.

Anonymous said...

That was funny---asd sad at the same time. If people took the time to read the warnings that accompny their drug purchases they would be less inclined to ingest them. So no Alaska this year???


Anonymous said...

I prescribe topiramate to patients occasionally, though it's more commonly prescribed by neurologists. It can be very helpful for certain conditions, but many people complain about its impact on memory and train-of-thought... likely why it's being studied in that regard.

Just off of the top of my head I can recall two patients who were disabled by their conditions, who got much better on Topiramate, such that they could return to work and enjoy spending time with friends and family.

Topiramate was developed as an anti-seizure medication. As one can imagine, uncontrolled seizures can substantially limit an individual. Effective treatment can be very, very helpful to these individuals.


Ken said...

Anon--They did tell me, actually. I got an email from two and a half months before the experiment, which I read, but forgot by the time my session came around. I'm not too worried about the professor--he had a sense of humor.

Mike--I'd invite you to my next study but I'm pretty sure I won't be taking drugs again. I still do the MRI studies every now and then but those aren't nearly as amusing.

Viv--I don't think Duke has a dental school, but some whitening wouldn't hurt.

Heb-- no Alaska, unfortunately. As much as I love the arctic, the job I had up there can be uninspiring sometimes. Plus, I really just wanted time for reading, writing, research, and to start and finish my book proposal! I'm not in the wild, but still a very natural setting.

Surgeon--thanks for the insights and helpful clarifications. I don't mean to criticize the drug. I presume--like some but not all drugs--that it serves some helpful purpose.

Anonymous said...

I take Topamax, which is the brand name for Topiramate. I take it every day. It's better for me if I do. Yeah, the cognitive side effects are really awful at first - and some of them do not go away completely - but most of them wear off. However, the physical and mental benefits far outweigh them.

Sorry your experience was so bad, but thanks for taking part in the experiment. I'm sure that they learned something from you. :)

Ken said...

Anon-- Glad to hear it helps. I was still suffering from mild confusion/cognitive issues up to a week later, and started fretting about possible long-term side effects. But those are gone, and I've had many lifestyle changes recently which may have been the real cause to the "haze" I was experiencing.

Akasha said...

I was prescribed topiramate and it was the worse drug I've ever taken. The nausea depleted my appetite to the point where I'd only eat if I got light-headed, and the impairment in my cognitive function disabled me from following simple conversations. But, just because topiramate sucks doesn't mean all drugs are bereft of utility. Read some Daniel Pinchbeck or Terrence McKenna and see if their words don't, at least, make you consider becoming a psychonaut ;)