Migraine

I started Zonegran 100 mg per day x 2 weeks, then 200 mg per day x 2 weeks and am just about to start 300 mg per day. I have not noticed any decrease in frequency or strength of migraines but I am so tired I'm having trouble going to work. I have been taking the dose at bedtime and then moved it up to about 7 pm but am still pretty tired. I am willing to keep trying a little longer if I can get around the sleepiness. Should this get better or is it just one of those things? I realize that the meds might take longer to work?
Thanks for the ideas...

I believe the tiredness with Zonegran generally decreases as your body adjusts to the med (aka "with time"). I've found that sometimes a slower titration schedule can help, where you make smaller mg increases in dose at each step and/or give your body a longer period of time to adjust at each step. It's definitely worth talking to your doctor about. Just be careful not to get up in the morning feeling tired and hit the coffee because caffeine can be a migraine trigger...

Hello and welcome to MyMigraineConnection.

So, you are at week 4 or so of Zonegran? With each dosage increase it takes our body at bit to adjust to the new dose. Some medications can take up to three months before we see a reduction in our Migraine attacks and any potential side effects may disappear. Only our doctors can help us with dosage recommendations and schedules. Have you discussed your sleepiness with your doctor or the pharmacist? If this persists you may want to do so.

One important thing to remember with this medication is you cannot suddenly stop taking it. A slow taper off the medicine is required.

Let us know how we can be of more help.

I totally can relate to what you're feeling from the Zonegran... I was sleeping between 17 and 22 hours/day. Even a slow titration didn't help... and it became apparent that I needed to talk to my doctor.

The final straw came when my DH called to check up on me- I didn't hear the cell phone, and he got scared and drove back home on his lunch hour- a 40 minute one way drive to check on me... and I was asleep... At about 1 pm.

I called my doctor, and we decided that this was not the preventative for me. I was lucky if I heard the alarm, cell phone, or any other attempt to wake me up if I had chosen to snooze. I was missing days of work at a time. Who knows... it could have been my wonderdrug, but I couldn't afford to keep going like that to find out. So, I went off it. I just couldn't deal with the excessive sleepyness, and my doctor agreed that waiting out that side effect wasn't feasible in my case.

So, I'd definitely recommend calling your doctor and discussing how you feel with him or her...If you all decide that it's not right, then so be it... Same deal if y'all think that it's a waiting game and you can deal with it for now... Whatever you decide, do so as a team, IMHO.

Hello

What you are going through is what I experienced with topamax. I could not get out of bed. I am going into week 4 on zonegran now I am only on 75mg and it agrees with me so far. I would check with your Dr sounds like you need to change to something else. Being too tired can be dangerous for I could hardly drive and I also would sleep through the alarm so that was why I made the switch.It just shows how different we all are and how it can work for one and not the other.
Lisa

Ummmmmmmmmmm. You STARTED at 100 mg twice a day? That could be why you're so tired. I really don't like second guessing doctors, but suggest you give yours a call.

Here's the dosage and administration section from the Zonegran prescribing info:
Adults over Age 16: The prescriber should be aware that, because of the long half-life of zonisamide, up to two weeks may be required to achieve steady state levels upon reaching a stable dose or following dosage adjustment. Although the regimen described below is one that has been shown to be tolerated, the prescriber may wish to prolong the duration of treatment at the lower doses in order to fully assess the effects of zonisamide at steady state, noting that many of the side effects of zonisamide are more frequent at doses of 300 mg per day and above. Although there is some evidence of greater response at doses above 100–200 mg/day, the increase appears small and formal dose-response studies have not been conducted.

The initial dose of ZONEGRAN should be 100 mg daily. After two weeks, the dose may be increased to 200 mg/day for at least two weeks. It can be increased to 300 mg/day and 400 mg/day, with the dose stable for at least two weeks to achieve steady state at each level.

It has a half-life of 72 hours, so my doctor started me at 50 mg EVERY OTHER DAY for a week, then 50 a day for a week, then 100 a day for two weeks. I had no problem other than a bit of a tummy ache and some diarrhea for a couple of days each time we increased my dosage.

Please keep us posted?

quote:

Originally posted by akhales:
I started Zonegran 100 mg per day x 2 weeks, then 200 mg per day x 2 weeks and am just about to start 300 mg per day. I have not noticed any decrease in frequency or strength of migraines but I am so tired I'm having trouble going to work. I have been taking the dose at bedtime and then moved it up to about 7 pm but am still pretty tired. I am willing to keep trying a little longer if I can get around the sleepiness. Should this get better or is it just one of those things? I realize that the meds might take longer to work?
Thanks for the ideas...