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Doc wants me to get off topamax and switch to Nortriptyline

I started at 25mg topamax and went up 25mg weekly to 100mg. I’ve been at 100mg for 2 weeks now and no improvement. He said to stop if I didn’t see anything at 2 weeks at the full dose.

I feel like I should stick it out longer on this medicine. Can’t it take months to work? I’ve only been at the full dose for 2 weeks. But then a part of me just wants to move onto the Nori because I heard that is the holy grail of vestibular migraine meds and it will help with my anxiety hopefully.

Should I stay on the topamax? I just feel it’s too soon. 6 weeks total and 2 weeks at 100mg. Also I have zero side effects if that reassures anyone. Don’t let the horror stories scare you. The only side effect I get is a tingle in my left foot that lasts for about 5 seconds about 4 times a week, that’s it.

Well every medic that has an opinion at all always seems to have a different one it seems. I cannot really see the need for you to hurry on to another med. General opinion is they can take anything up to four months however I have a feeling many people taking Topamax do seem to have had good results extremely quickly, days rather than months I have read on here. I am sure one doctor I spoke to told me if I did decide to try it one way or another ‘you would soon know’.

From memory you have already passed on some other meds, Propranolol and Verapamil as unsuitable. One plus for you with Topiramate is the no side effects. The grass on the ‘other side’ always seems greener but Nortriptyline brings no guarantees with it either. As one neuro told me choosing preventative drugs is always just trial n error. What works for one doesn’t work for another.

Might I suggest you ask your doctor for his opinion on how long he thinks you would need on Nortriptyline before maybe needing to move on again. The answer might give you some insight into his mindset before making a decision.