Migraine

What preventative has shown the least amount of side effects?? Just curious?? Thanks

Hello and welcome!

Wow! What a question. OK, let' see. This one is very hard to answer because our bodies can react so differently. So, let me take a different approach -- which preventives have the lowest profiles of potential side effects (SEs)?

Part of this depends also on whether you have other conditions that make it hard for you to take certain types of meds. For example, beta blockers such as propranolol tend to have fairly low potential SE profiles, but are usually not good for someone with asthma.

Verapamil, a calcium channel blocker, also has a relatively low potential SE profile.

The neuronal stabilizing agents, aka anticonvulsants (Topamax, Depakote, etc.), are being prescribed with more and more frequency. Among those, Zongegran has the lowest potential SE profile.

Is there any particular medication or type of medication you've been discussing with your doctor?

Welcome again!

Yes, my nuero has prescribed topamax. I'm still in the tapering phase so I'm getting side effects like I'll notice my muscles will tighten up for no reason- weird huh?? Also, what is the significance of taking it in a split dose? My doc says I don't have to but should I? Thanks

Hello again!

There are two reasons for split dosing:

1) The half-life of Topamax is 21 hours, so if you take it only once a day, it doesn't maintain a steady level in your bloodstream. That decreases its effectiveness.

2) If you have side effects, they're dose dependent. The higher the dose, the worse the side effects. Taking it in two doses per day reduces the potential for side effects.

I can't give you medical advice, but I can tell you that if my doctor prescribed Topamax and told me I didn't have to split the dose, I'd be looking for a new doctor. All of the information available about Topamax, including the "official" prescribing information and the reports from all the clinical trials say to take it in split doses once you do your first increase on the taper. It also says not to start at more than 25 mg per day. I don't know what your starting dosage was.

Topamax is a great medication for a lot of people. It's also the medication that we have the most complaints about because of side effects.

What kind of doctor do you see?

Now, I'm seeing a migraine specialist but that wasn't who originally prescribed the topamax to me (it was my family doc). My migraine specialist said he wants to stop my current migriane before we analyze the side effects of the topamax ( to give it a fair shot). Thought that was a good idea but I am having second thoughts about this topamax

I'll add my two cents. FWIW, I agree with your specialist that you need to get out of your current migraine cycle before you start tampering with the Topamax. Some of your symptoms might be migraine, not Topamax side effects.

Topamax might actually be the preventive for you. Give it a fair trial. Lots of people have found that any side effects they've had disappear with time, and it's a wonderful drug.

Hang in there!

Gretchen in Mississippi

So, Teri, what do you think would be a good "migraine cocktail" to get rid of an almost 3 week migraine? Last week my doc gave me a shot of toradol that didn't touch it. I'm soo new to this migraine game! Thanks!!

Welcome litlalex!

I just say this and wanted to add that I had the cramping/tightening effect on a higher dose of Topamax as well.

Once I had reached 100mgs I had this effect in my calf so much so, that it was difficult to walk. I backed down to 75mgs (25mgs am, 50mgs pm) and the Topamax is good again. The side effect went away and has not come back.

That's just me though.

Thought you'd like to know you're not the only one with this side effect, since it isn't as common as some of the others, like tingling in hands and feet.

Good luck to you and welcome to the forum!

quote:

Originally posted by litlalex:
Yes, my nuero has prescribed topamax. I'm still in the tapering phase so I'm getting side effects like I'll notice my muscles will tighten up for no reason- weird huh?? Also, what is the significance of taking it in a split dose? My doc says I don't have to but should I? Thanks

I'm glad you're seeing a specialist. That has made a world of difference for many of us.

You and your doctor both have good points. I have to agree though that it's hard, if not impossible, to tell how you're really reacting to a medication if you're in the midst of an extended Migraine.

Hopefully, your specialist will really discuss your options with you and partner with you to make decisions together.

Please keep us posted?

quote:

Originally posted by litlalex:
Now, I'm seeing a migraine specialist but that wasn't who originally prescribed the topamax to me (it was my family doc). My migraine specialist said he wants to stop my current migriane before we analyze the side effects of the topamax ( to give it a fair shot). Thought that was a good idea but I am having second thoughts about this topamax

I'm still a walking migraine so i'm throwing in the towel on this topamax- i think it's trash (for me at least) .
I feel like I'm still on speed and my status migraine hasn't gone away so i'm done- plus i don't sleep well. so would you say i should stay in the same class of meds or a different class of meds (since the topamax hasn't broken the migraine)- here's the kicker- i feel like keppra if given a good chance, could have. those were the best three days (my iv treatment days with keppra) in 4 weeks!
But at the same time i'm more comfortable (especially considering my wonderful- kidding- experience with topamax) with an older, more tested medicine.

Thanks

Please make sure to consult with your physician before you stop the Topamax. Depending on the dosage you are on you may need to taper off it it to safely go off of it.

Teri or one of the others will address your other questions. I just saw your comment about stopping the medication and just wanted to make sure you did not do so aburuptly and possibly have additional difficulty!!

Take care,
Cindy

yeah, i know...I might have seizures if I do that

cindy, i know you were one of the ones that commented a while back that you felt like you were walking around with a migraine and you changed your meds and it worked wonders- i totally feel like that right now- i'm hoping that changing my meds works as fast for me too