Hello, I'm new here. Question re: meds

Hello to all you fellow dizzy people, :smiley:
I am new to this site but not new to the dizzy world. Have had dizziness and related symptoms for the last 7 years and I have recently been diagnosed with MAV. I finally feel I have the correct diagnosis after trying on all the others. My symptoms seems to be like everyone elses here and I get through each day by learning to be in the moment. I’m not one for making many plans anymore. We never know what tomorrow will bring, right?

My question is about MAV medication. My neurologist wants me to start topamax and my GP wants me to start taking zoloft for both the depression I have been suffereing from (due to the chronic nature of the MAV) and as a migraine prevention. I’m not sure about which one to take. I don’t want to take both at least not right off the bat. If I start taking topamax and it relieves the migraines, will that end the depression? Or if I kill the depression will that end the MAV? I heard those two disorders are related. And I heard that only tricyclic antidepressants work as a migraine prevention (I can’t take those) and that the SSRI"S like zoloft are not as effective. My GP says they are. I’m just confused. What does everyone else take? I personally would rather take an SSRI over topamax since the side effects are not as bad, but I am wondering if anyone else has found SSRI’s to be effective for migraine? Sorry for the long winded post…

Halfthere,

First of all, your post was hardly long-winded, and even if it were, not to worry.

I’m curious as to why your neurologist and your GP are both prescribing for MAV. I would think your GP would leave that to your neuro, unless he/she is just giving some input. And i agree, i would not start two meds at once. I’d actually be more worried about starting an SSRI than Topamax. I had to cut my Zoloft into 1/8 or 1/4 to avoid hallucinations. In addition, if you get relief from MAV how will you know which one is working? Zoloft and Topamax titration at the same time? Muddy waters!

anyway, you’ll find that these doctors all have their favorite meds to prescribe, probably based on their successes with each. And I’m beginning to think that their successes with a particular med may have to do with their individual prescribing abilities with a certain med.

For example. My doc, has his best success with Zoloft, with specific instructions, and it did a great job for my depression, but little for my MAV. After striking out with 2 other meds he finallyh put me on topamax, but gave me no instructions, aside from take 25 mg until i see you again in 3 months. :shock: so i had to come up with my own system, which has worked well. In the meantime, one of the members of this forum read my post and was kind enough to pass on Dr. Hain’s prescribing method for Topamax which is detailed to the max - regarding dosage, symptoms and SEs that come up. I would say he is a master prescriber of Topamax and I have integrated it with my own system and it’s working great. So Topamax happens to be Hain’s favorite, he works very well with it. Effexor, as far as i can tell, from anecdote, is his second choice, he also gives detailed instructions with that med. (SSNRI)

We’re all different. You can find many stories on this forum where Topamax didn’t help, or that it helped great but SEs were too horrible. Hain claims that he has treated 10,000 migraines with a 98% success rate, and that Topamax and Effexor make up 80% of his practice - for what it’s worth. I have had no problem whatsoever with SEs but that could be because I cut those pills into 1/4s for my titration.

I hope others will jump in with their thoughts on this - i’m thrilled with my success with Topamax, so far, but i’m still not able to drive because of motion intolerance, i have a long way to go. I think i’m looking Effexor right in the face.

So - halfthere - how’s that for long-winded? :slight_smile:

Julie

Hi Halfthere

Welcome to the site! I am also a relative newbie and I have found it to be a very supportive and welcoming site.

I’m afraid I can’t really help with your SSRI: Topamax question as I haven’t been on either for migraine. In ‘Heal your Headache’, David Bucholz says that SSRIs are not effective against migraine but TIm Hain uses Effexor which he says is 80% effective. I think Effexor is an SNRI rather than an SSRI so perhaps this is the difference and maybe that’s worth a try? (Please can anyone correct me if I’m wrong!)

With regards to your question about whether treating your migraine dizziness in isolation would solve your depression, I guess you would have to take into account other factors in order to make your decision and ask yourself questions such as; did the depression start after I became ill? Have I any other stressors in my life that may be contributing to the depression? And whether you have a history of depression.

Anyway, sorry I can’t be more help but welcome anyway.

Becky

PS. Julie - Please don’t worry about going on about your success with Topamax, its brill to hear a success story!

B

Thanks Becky :slight_smile:

I forgot to mention, this Hain patient has also, with his instructions on titration, suffered no SEs from Topamax except for some minor tingling, and he instructs her to hold her dose until that goes away. so, none of this tongue going numb stuff. Same for me, just some minor tingling in my fingers and it goes away before i take my next step up.

Julie

Halfthere,

Have you talked to your neurologist about the Zoloft? I would let him guide your medication trials. You may end up taking both, but it is probably best to start one at a time. From what I have read, Zoloft hasn’t proven to do much for “traditional” migraine prevention but it can help with the MAV. I know Julie has had success with it. I just started taking Zoloft last week, so it is too soon to tell. I took it many years ago for depression. It helped, but I remember feeling a bit anxious on it. I made the mistake of quitting it cold-turkey. The results were very similar to MAV symptoms.

On the other hand, Topamax can actually cause depression for some people. I haven’t had this experience, but then I have been on an antidepressent since starting it. (I am currently titrating off of Wellbutrin.) I’ve been taking Topamax since the middle of May. I currently take 50 mg. twice a day. I do have side effects - fatigue, confusion, and tingling in my face, hands, and feet. I already had all of those as MAV symptoms, but they are worse with the Topamax. On the positive side, Topamax has helped my headaches. I didn’t have bad headache, but I had one almost every day. Now I only have one every 1-2 weeks.

Has your doctor ever mentioned Verapamil? It has helped me and others with the vertigo. Also, are you following the migraine diet?

Good luck!

Marci

Halfthere,
I had the same thought as Marci - “Why aren’t they trying Verapamil?”. Because it usually has few side effects it is often considered a “first line” treatment. In my case I had a pronounced improvement when I started taking it although, as I mentioned in another thread, I also made some lifestyle changes about the same time so I’m not entirely sure that Verapamil is responsible for the improvement. Anyway it seems there is a trend among the doctors to jump straight to SSRIs or tri-cyclics without first seeing if drugs that interrupt the migraine process at the vascular level (ie Propranolol, Verapamil, etc.) might be effective. I’m not sure this is a good thing. Personally I wouldn’t want to be taking an anti-depressant if something simple like Verapamil would give me good relief.

Best of Luck

Chaz

— Begin quote from "MarciM"

I know Julie has had success with it. Marci

— End quote

I had great luck with Zoloft for my depression but NO luck with it for my MAV.

Chaz, are you still taking Verapamil? If so, is it still helping as much as it was in the beginning, and with no SEs?

Julie

Thanks for the info and quick responses! :smiley: I think it is great and so helpful to hear about what other people experience with medications.

You know, I was wondering why I didn’t get prescribed verapamil too. I have heard from so many others who have been helped considerably once they started verapamil. I would like to try that one but I think the Dr. wants me to try the topamax first. I guess it can’t hurt to try it and then ask to be switched to a different one if it doesn’t work out. I get concerned thinking about the vision SE though. Since visual disturbance is one of the 1st signs I have a migraine coming, I won’t know if its the topa or the migraine. I will discuss that with the Dr. But I guess if Dr. Hain is having success with it, then it must not be too terrible. I know they have to list the scariest symptoms even if they happen to only one in 5000 people or something like that.

Julie,
Something is certainly helping. Weather its the Verapamil or the lifestyle changes I’m not sure. Basically all the debilitating symptoms are under control. I’d say I’m 100% functional. I am still dealing with some subjective annoying symptoms - for instance the “feeling” that my balance is not as good as it should be in a dark room. But this is nothing compared to the episodes of spinning vertigo I was experiencing a few months ago. As far as side effects, I’d have to say almost none. I’ve started running for exercise for the first time in years and I may be seeing a bit of exercise intolerance. Then again I may just be fat and out of shape. I’ve noticed headaches a bit more since I’ve been on it but they are infrequent and not debilitating. This may well have nothing to do with the Verapamil. In short I feel like, even if I don’t make further improvements, I’ve got my life back. I just hope I don’t back slide.

Chaz

In other words, you are doing great on the verapamil, plus the lifestyle changes, with no SEs. and who knows what’s doing what, but whatever, something is working.

yea, i wonder why these hot shot docs claim they have little success with verap and prop - from their mouths to my ears to this post - i emailed a handful of them.

you can’t walk so well in the dark? things could be much worse!

Good for you Chaz, you’ve got your life back !!! Remind me, how long were you sick?

Julie

First acute symptoms (spinning vertigo) showed up right at 3 years ago.

oh, and i forgot - a big thank you for getting your life back and letting us know about it.

As you know, one of our theories is that there are so many bad stories on this forum because people who get their lives back just don’t bother logging on anymore.

Thanks for letting us know that we’re not all doomed to living a hell on earth.

Julie