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Topamax: I love you!

JC Jones MA RN

Today marks the first month in years that I am migraine free, thanks to Topamax. I was really grateful and a little apprehensive when my doctor prescribed sumatriptan injections for the incapacitating headaches that crippled me about 11 years ago. I had been struggling with migraines for a few years, but as a recently widowed mother of an active toddler, I really could not afford 24-48 hours of incapacitation and irritability. At that time, I lived in a rural community, one mile from the nearest neighbor, had a small farm with lots of animals and in addition to raising my daughter and grieving the death of my husband, I was running a busy consulting practice. Who wouldn't have migraines? I get agita just remembering those days.

Your doctor warns you not be alone the first time you give yourself an injection of Imitrex, so the scene of me carting my little daughter and all of the toddler paraphernalia, my injection kit and paraphernalia over to my neighbor's house is indelibly etched in my memory. Migraines are a type of vascular headache, the result of the blood vessels in the brain dilating. Imitrex works by constricting the blood vessels, but one of the problems is that migraines are so localized. The excruciating, tortuous pain comes from one blood vessel in one small area of the brain. Imitrex constricts the blood vessels in the entire body, so for first time users or people with known risk factors, there is the danger of cardiac complications to watch for. My neighbor Tammi entertained my daughter while I wiped my thigh with alcohol and shot the spring loaded auto-injector dose into my skin. After about ten minutes I could feel tightness as the blood vessels in my throat constricted and within twenty minutes I was headache free. This was a miracle, and soon Imitrex manufacturer GlaxoSmithKline made available the much more convenient and less dramatic triangular white tablets. I admit to feeling somewhat like a junkie about my Imitrex. I had to have a pill on me or nearby at all times. I lived in fear of the next migraine. I lived in fear of not having access to Imitrex, so effective is it in relieving the agonizing pain of a migraine, and relieving it fast. I never miss a day at work or my daughter's ballet performances due to a migraine. Imitrex relieves the pain in about twenty minutes and I can keep on going.

Over the years I radically changed my life and lifestyle to prevent migraines: reduced stress, learned the triggers (alcohol) and avoid them as much as possible. Tried lots of alternative therapies like acupuncture, cupping, massage, hot rock treatment, craniofacial massage and meditation. I have had shamanic healings, Reiki healings, if there is something out there, I have probably tried it. I'm insatiably curious about everything and everyone (my detractors say I'm nosy). Migraines have not defined my life.

Until two months ago. I started getting rebound headaches after taking Imitrex. Really, really bad ones. Headaches so bad I spent weekends in bed, getting up only to throw up, taking Phenergan and Percocet to sleep and cut the cycle. Now my daughter is a teenager and any parent of a teenager can tell you, they need you at least as much as toddlers do. Unacceptable to be unavailable to them.

Years ago, a doctor had recommended Inderal to me for preventing migraines. I wasn't sold on the idea of a vascular solution. I researched (using Healthline) what medications are being used to prevent migraines in the first place. Based on my understanding of neurophysiology, I decided I wanted to try something that would change neurotransmission, as it is my belief that is what triggers the migraine response. I decided to try Topamax as it had the fewest side effects, based on my research. I made an appointment and discussed it with my doctor. I walked out of his office with a prescription and a sample.

I started out a month ago on a dose of 12.5 mg in the evening. You have to take Topamax with a full glass of water. After a week, I increased my dose to 25 mg in the evening. I had a few mild (+2/10) headaches so I increased it to 25 mg in the morning and the evening the following week and am happy to report I have been migraine free for a month with no side effects. If this blog post helps just one person find relief, I am happy.

Full disclosure: Ortho McNeil Neurologics, Inc. doesn't even know I exist. They do advertise on our site but I receive no benefit from that nor have I had any conversation with anyone about that. My sister manages a neurology practice on the East Coast and she really likes the Ortho McNeil Neurologics, Inc. pharmacy rep who visits their office. My doctor gave me a sample of 42 (?) 25 mg pills but I am now paying my co-pay that insurance doesn't cover. I still carry my Imitrex just in case.

Thank you ADAM illustration Team for use of illustration.

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4 Comments:

  • At Thu Nov 29, 10:25:00 PM 2007, Anonymous Anonymous said…

    Topamax is a horrible drug with dangerous side effects. Yes, my headaches went away, but the rest of my body was in terrible shape when I was one Topamax. I would never recommend it to anyone!

     
  • At Wed Aug 13, 09:09:00 PM 2008, Anonymous Misty said…

    Thank you for that information on migraine treatment with topamax.
    I too have had them for years. Imitrex worked great for many years. Recently have been getting such bad rebound headaches, that seem to be worse than the original migraine. Will be seeing a Neurologist next month to discuss going on topamax. Hope that it helps.

     
  • At Thu Aug 14, 11:53:00 AM 2008, Blogger JC Jones MA RN said…

    Hey Misty
    Thanks for your comment. I hope Topamax helps you. The rebound HA's I experienced were vertebral artery HA's (the back of my head). I have been able to cut down the Topamax to 25 mg in the AM only with no discernible side effects and the rare migraine. Keep us posted! jc

     
  • At Sat Aug 30, 07:30:00 PM 2008, Anonymous diane said…

    Topamax helped me too. I'm on a much higher dose (300mg) and it REALLY cut back my pain from an almost daily 7-8 down to a 4-6 lasting only 3-4 days every few weeks. I have this funky mixed type headache problem, as yet really undefined. But let's just say Chronic Daily mixed with migraine. So I treat the worst with Imitrex and tough out the others with relief meds if I can't stand it. For me, it was getting rid of that chronic daily at the high level and Topomax did it.

    I did have some tingling in the hands and feet for a few weeks with each increase, esp. in cold weather. But that has gone away. I also lost some weight at the beginning but now I eat like a horse again, so don't let that sway you. I've been on it about 3 years. It's starting to lose it's effect again, so I'm going back for some tweaking. That's still ok, I've had a fantastic summer and I'm really happy.

     

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