Dr wants me to start Topamax

Hi all, my current regimen is 20mg citalopram, 30mg (recently raised from 20mg) amitriptyline nightly. Naratriptan 2.5 with 440mg naproxen as an abortive (max of 2 naratriptan-4 hours apart-1x/week).

I’m still have chronic daily migraine, and at least 1 severe migraine a week! I have a current streak of around 3 weeks since my last break in migraine, which was only 1 day break, and the last migraine-free day before that was a good 3 weeks as well. I’ve taken my naratriptan each week, but it’s failed to break the migraine compeletely.

My neuro wants me to drop the Ami to 20 mg and start Topamax 15 mg tonight. Citalopram stays at 20mg. I’m also starting a 6-day prednisone med pack, starting tomorrow morning, to try and break through this streak.The Topamax is to be raised every 2 weeks until 45mg.

Has anyone had an experience with this? I’ve researched the forums, but it seems to be an odd starting dose and ending dose. What I can expect for side effects? Is this being raised too fast (as far as side effects are concerned), or is it ok since the starting dose is only 15mg vs. the average 25mg? I’m really scared to try this med, but I’m also really excited to see if it actually helps with my migraines! Especially the horrible, completely debilitating fluorescent light intolerance!!!

Hi candikane

You poor thing! It sounds like you’re having a terrible time!

I’m new to topamax and I’m sure there’s better people to give ‘success stories’, but I’d say give it a go.

Everyone’s experience is different. I have personally found it challenging to get to 50mg with some increased symptoms along the way, but others don’t at all. However, I’ve also stuck it out as it helped so many.

I am also on ciprimil 20mg with my topamax.

I’m not sure about your dosage. I only started on 12.5mg and went up by 12.5mg each time (every 2-4 weeks.) I am aiming for 100mg those as many seem to find they need higher doses for relief. Some find relief at just 50mg! We are all different. It may be a case of just trying it and seeing how you go.

If you search topamax on here there is so much info :slight_smile:

CandiKane: My daughter has been on Topamax since Jan - she is 13 yrs old. She had the 15mg pills which is a pediatric dose, and she increased by 15mg every 2 weeks. I think even if you’re an adult this would be an OK dosage. I know that adults are given 25mg pills but I’ve read on this site that many of them cut them in half and increase by 12.5mg. My daughter got up to 75mg but then we decreased by 15mg each 2 weeks (she’s at 45mg now) because of the side effects. She has nausea constantly, to the point where she doesn’t want to eat anything, and her memory & thinking got worse. The memory thing was what made the dr. reduce her dose, and we’re hoping to go off this med and try something else. I was disappointed as I’ve read that Topamax has helped so many… Everyone responds so differently to all these meds., that I think you have to give each of them a try until you find the one(s) that work for you. I’m looking forward to getting started on the next one so we can find something to help my daughter reduce the 24/7 dizziness she’s had for just over a year now…we really want to get her back into school and the rest of her life.

Please let us know how the prednisone pack goes, as the neuro has talked about trying this with my daughter. We see him on Fri so we may be following you in doing that.

Good luck with your trials.


I wouldn’t worry too much about the Topirimate titration- just see how you go and if you do find it’s affecting you massively, just go slow. You won’t be doing yourself any harm by staying on a lower dose for longer and no doubt thats what your doc will tell you to do.

Did he say why he wanted to reduce Ami?


Also v interested to see how you go with the steroid thing… They dont often do that here in the UK

Thanks for the replies!

I’m going to give it a shot and start the Topamax tonight. It’s scary as heck for me, because I’ve heard soooooooo much bad about it and so very little good, but I need to give it a try. My Dr wanted to lower Ami because I’ve been on it since last November (started at 10mg) and it only seems to help a little bit, and then stops helping altogether. An increase will make it work for a bit again, but then again stops helping at all. I’ve been having a really bad time lately and much more elevated migraines, so rather than continuing to increase it they decided to have me give Topamax a shot. I had JUST increased to 30mg from 20mg a week prior to the appt, so I’m assuming they had me drop back to down in order to start the Topamax immediately and avoid being clueless of a culprit if side effects start to emerge.

I’m holding off on the prednisone right now due to illness, some kind of virus that has one side of my throat swollen and I’m more exhausted than ever. I go back in for trigger point injections (round 2) later this month, and we’re going to discuss the prednisone at that time to see if it’s still needed (assuming I’m symptom-free).

Good luck and let us know how you get on x