Hi I have been suffering from vestibular migraine for the last 4 months. The first medicine I was given was Amitriptyline, after 2 weeks of terrible paradoxical insomnia and depression, the Doctor stopped it and prescribed me Propanolol. I have been in 40 mg of propanolol for the last 6 weeks, but I still have a lot of vertigo. The Doctor has told me to stop propanolol cold feet and start with Topamax. I am so scared on changing medicine considering what I went through with Amitriptyline. I am scared of getting the insomnia and depression and all that comes with leaving one of this medines and starting a new one. Is there any success story here where Topamax was the medicine that made a difference and stop the Vertigo and Vestibular Migraine Flares?
Topamax was a game-changer for me. It doesn’t eliminate all of my VM symptoms but it largely stops the vertigo. Give it a try.
I’m sure the doc has good reasons for switching you off propranolol, but just FYI I didn’t feel a major difference with propranolol until I ramped up to 120 mg daily. I bumped up every 2 weeks - started at 60, then 80, then 120 after 4 total weeks. After 3 days on 120mg I woke up and felt like my symptoms were 80% gone overnight. Eventually they started coming back so I went to 160mg and remained stable at that dose for more than a year. I only eventually got off propranolol because I am quite active, and it was a bit of a hassle to have it limit my heart rate when I was exercising.
All that said, Topamax is relatively effective, and according to my neurologist, you don’t have too many issues with it as long as you start very low and go very slow on dose increases.
You could do research using Chat GPT regarding the effectiveness of Topomax for VM. Ask about the pros and cons of Topomax. I know many people think AI is dangerous, and it could be; however, I am impressed by the amount of information I can gather myself. I do lots of research regarding medications, and I talk with my neurologist based on that information. It is easier to talk with your doctor when you are educated about the pros and cons of the options offered to you.