Went to see the great Adrian Priesol yesterday. He is a neurologist who specializes in vertigo at Mass Eye and Ear in Boston. He works with ENT Dr. Steven Rauch.
- Learned that I get a lot of good information from this site, from the many books I’ve read, and a few friends who’ve helped along the day. I am pretty much on the right track with management of this thing.
- Certain meds “reset the brain” so that you can eventually go OFF meds, and certain meds “treat the symptoms” but don’t help in the long run. I am on one of each. Amitriptyline and Klonopin. Obviously Amitriptyline is the “reset” drug.
- His go to drug is Nortriptyline (less side effects than Ami) but they work the same way. I may need to keep titrating up until symptoms subside. My 20mg is very low. Wait 6 weeks before titrating up.
- Almost all migraine drugs cause weight gain except Topamax (weight gain is an issue for me as it brings on high BP.) Topamax often has many cognitive SEs.
- Stress management is key - yoga, and Tai Chi especially, are good for stress management, so that when you have stress you can learn to replace the “fight or flight” response with calming alternatives.
- When having a flareup, go back to the elimination diet and add more meds. Figure out triggers one at a time. Eventually, with the correct meds dosage, good trigger management and many months of stability (I think he said 3 months but for me that seems too short) you should be able to get off meds. 90% of people can get off meds this way. 10% will continue to struggle until they find the right level of meds to “reset the brain.”
- Things get better as you age, especially women who are more affected by hormones.
- Take 200mg of Riboflavin 2x a day and 400mg of Magnesium 2x a day.