The wiki support on this site has a Drug Treatment section. A few posts in @Manatee has a post with a pretty exhaustive list of the all meds you can try Drug Treatment
Take your pick. I asked my specialist why he favoured one drug over another for patients and he said it depended what he thought would be effective for their age and other conditions they may have. So, if you had high blood pressure then a blood pressure med might treat both conditions,e.g. if you were suffering a high level of anxiety (because of or in addition to MAV) then he’d prescribe a med like Lyrica (Pregablin), if you were a menopausal woman and having a hard time with hot flushes etc then perhaps Clonidine, if you were young noritryptiline or amitryptiline - you get the picture. He also said he used his experience of seeing lots of people with MAV and keeping track of what worked and what drug the patient would actually agree to take. He said the main thing was to get on a drug, any med as long as you could tolerate the side effects and so would be likely to give it a good trial and he increases dosage slowly and recommends staying on a dose before increasing again for a few weeks.
In my experience some doctors have favourite drugs . If you scroll down a bit on this site there is a flowchart that Dr.Hain uses to help decide med treatment:
I’m sorry your Topomax combo didn’t work for you.