How do you know if your meds are working?

Kind of a general question about all meds.

I know this sounds stupid, but how can you tell if your med is working. I mean I would assume you would be feeling better, but for most of the drugs I’ve seen listed on here there’s a fairly long (month to 6 weeks) of trail before you know.

Is it that you wake up one day and go ‘wow, I feel better,’ or is it ‘you know, the past week wasn’t as horrible as the week before’ ?

I’m new to MAV and on my first med…Verapamil. I wasn’t having any side effects so I was up to my full dose (360mg) within a week. That was 5 weeks ago and absolutely no change/improvement.

Any advise is welcomed
Judy

Well, for me I was able to identify my triggers, so I knew exactly how to trigger a migraine, and also the exact feelings I would get when I exposed myself to my triggers (numb/fog brain that quickly progressed into the rocking sensation that got worse and worse with continued exposure).

I knew the medication was working when I could expose myself to the triggers and the sympotms no longer occurred. I’ve been on Topamax for 4 months and I haven’t felt the rocking sensation in over 3 months now. So that is a pretty good indication that the med is working!

I realize for a lot of people trigger identification isn’t quite so obvious. For me, bright artificial light and anger were the two things that set me off. I was pretty asymptomatic if I could avoid those two things. I was never 24/7 like some people, which made it easier for me to track down what was going on.

Thanks Jamie

I’m a 24/7 person. Sounds though that you did notice a difference after a month. So glad you were able to find a med that works!

Thanks again,
Judy

Hi beachgal

I don’t think there is any specific way that you can tell if the medicine is working. I can only explain by giving my own experieces. My first medicine was pizotifen. As it was my first and this was during the chronic phase of this stupid disease I was just lost and had no idea how I was going to react and what class of medicine I was taking. All I riemember is that it made my anxiety super worst. I reached the full recommended dose but had to quit after 1 month eventho it was not a fair trial.I shud have been on the full recommended dose for 2 months which is what Dr.granot recommends.my next med was epilim and once again altho I took it for 3 months,I was never on the full recommended dose.not sure why my neuro in singaPore decided to reduce the dose one day.my.third med was cymbalta.the cymbalta reduced my head pressure and dizziness almost instantly within 3 to 4 days but didn’t completely take it away.and I also noticed that I had stopped crying all the time bcz it was suppressing my anxiety.now after 5 months on it I still do get anxious but its nothing that I can’t handle as I always keep valium with me as back up and take it when needed.Dr granot stopped me from taking epilim and added periactin. After 2 weeks on the periactin I started to notice my dizziness had improved dramAtically and my head pressure was almost gone. So now I’m on both the periactin for te Dizziness and cymbalta for the anxiety. Altho both these symptoms
s still do exist, but nothing I cannot handle so I am happy with the result and hope to reach 100% one daythough vision is still scewed up and has not improved at all so I’m trying to adapt to it which is noteasy.the epilim And pizotifen I tried effexor and flunarizine for 3 weeks. Once again I do not know why, my neuro in singapore took me of them so early.but it was after the epilim when I started doing a lot of research and started to understand what I was dealing with and what to expect from each class of medicines.I think u

Hi beachgal

I don’t think there is any specific way that you can tell if the medicine is working. I can only explain by giving my own experiences. My first medicine was pizotifen. As it was my first medicine trial and this was during the chronic phase of this stupid disease I was just lost and had no idea how I was going to react and what class of medicine I was taking. All I remember is that it made my anxiety super worst. I reached the full recommended dose but had to quit after 1 month eventho it was not a fair trial.I shud have been on the full recommended dose for 2 months which is what Dr.granot in Sydney recommends.Dr. cremer in Sydney took me off the pizotifen as he thought my symptoms were purely due to anxiety and had nothing to do with migraine. He put me on effexor xr and told me to titrate up every month. Unfortunately I cud not go past the starting dose due to side effects.my next med was epilim which my singaporean doctor put me on and once again altho I took it for 3 months but I was never on the full recommended dose.not sure why my Singaporean neuro didn’t prescribe the full recommended dose. I was also started on flunarizine at the same time as the epilim and the same Singapore based neuro stopped me from taking it after 2 weeks. To date I don’t understand why he did not let me continue the flunarizine and why he gave me a reduced dose of epilim.I do know that he thought my symptoms were caused by sumthing else and not migraine.the one good hing he did do was that he put me on cymbalta to take with the epilim.the cymbalta reduced my head pressure and dizziness almost instantly within 3 to 4 days but didn’t completely take it away.and I also noticed that I had stopped crying all the time bcz it was suppressing my anxiety.now after 5 months on the cymbalta I still do get anxious but its nothing that I can’t handle and I always keep valium with me as back up and take it when needed.Dr granot stopped me from taking epilim eventually as it wasn’t doing much and added periactin to the cymbalta. After 2 weeks on the periactin I started to notice my dizziness had improved dramAtically and my head pressure was almost gone. So now I’m on both the periactin for the Dizziness and cymbalta for the anxiety. Altho both these symptoms still do exist, I am quite happy with the result so far and hope to reach 100% one day though my vision is still scewed up and has not improved at all so I’m trying to adapt to it which is not easy. So I guess in my case I can say that I.did not give pizotifen and effexor xr and flunarizine enuf time to see if they actually worked. It was only after the epilim that I started doing a lot of research and started to understand what Illness i was dealing with and what to expect from each class of medicines.I don’t think there is any specific way that you can tell if the medicine is working. I can only explain by giving my own experiences. My first medicine was pizotifen. As it was my first medicine trial and this was during the chronic phase of this stupid disease I was just lost and had no idea how I was going to react and what class of medicine I was taking. All I remember is that it made my anxiety super worst. I reached the full recommended dose but had to quit after 1 month eventho it was not a fair trial.I shud have been on the full recommended dose for 2 months which is what Dr.granot in Sydney recommends.Dr. cremer in Sydney took me off the pizotifen as he thought my symptoms were purely due to anxiety and had nothing to do with migraine. He put me on effexor xr and told me to titrate up every month. Unfortunately I cud not go past the starting dose due to side effects.my next med was epilim which my singaporean doctor put me on and once again altho I took it for 3 months but I was never on the full recommended dose.not sure why my Singaporean neuro didn’t prescribe the full recommended dose. I was also started on flunarizine at the same time as the epilim and the same Singapore based neuro stopped me from taking it after 2 weeks. To date I don’t understand why he did not let me continue the flunarizine and why he gave me a reduced dose of epilim.I do know that he thought my symptoms were caused by sumthing else and not migraine.the one good hing he did do was that he put me on cymbalta to take with the epilim.the cymbalta reduced my head pressure and dizziness almost instantly within 3 to 4 days but didn’t completely take it away.and I also noticed that I had stopped crying all the time bcz it was suppressing my anxiety.now after 5 months on the cymbalta I still do get anxious but its nothing that I can’t handle and I always keep valium with me as back up and take it when needed.Dr granot stopped me from taking epilim eventually as it wasn’t doing much and added periactin to the cymbalta. After 2 weeks on the periactin I started to notice my dizziness had improved dramAtically and my head pressure was almost gone. So now I’m on both the periactin for the Dizziness and cymbalta for the anxiety. Altho both these symptoms still do exist, I am quite happy with the result so far and hope to reach 100% one day though my vision is still scewed up and has not improved at all so I’m trying to adapt to it which is not easy. So I guess in my case I can say that I.did not give pizotifen and effexor xr and flunarizine enuf time to see if they actually worked. It was only after the epilim that I started doing a lot of research and started to understand what Illness i was dealing with and what to expect from each class of medicines.I don’t think there is any specific way that you can tell if the medicine is working. I can only explain by giving my own experiences. My first medicine was pizotifen. As it was my first medicine trial and this was during the chronic phase of this stupid disease I was just lost and had no idea how I was going to react and what class of medicine I was taking. All I remember is that it made my anxiety super worst. I reached the full recommended dose but had to quit after 1 month eventho it was not a fair trial.I shud have been on the full recommended dose for 2 months which is what Dr.granot in Sydney recommends.Dr. cremer in Sydney took me off the pizotifen as he thought my symptoms were purely due to anxiety and had nothing to do with migraine. He put me on effexor xr and told me to titrate up every month. Unfortunately I cud not go past the starting dose due to side effects.my next med was epilim which my singaporean doctor put me on and once again altho I took it for 3 months but I was never on the full recommended dose.not sure why my Singaporean neuro didn’t prescribe the full recommended dose. I was also started on flunarizine at the same time as the epilim and the same Singapore based neuro stopped me from taking it after 2 weeks. To date I don’t understand why he did not let me continue the flunarizine and why he gave me a reduced dose of epilim.I do know that he thought my symptoms were caused by sumthing else and not migraine.the one good hing he did do was that he put me on cymbalta to take with the epilim.the cymbalta reduced my head pressure and dizziness almost instantly within 3 to 4 days but didn’t completely take it away.and I also noticed that I had stopped crying all the time bcz it was suppressing my anxiety.now after 5 months on the cymbalta I still do get anxious but its nothing that I can’t handle and I always keep valium with me as back up and take it when needed.Dr granot stopped me from taking epilim eventually as it wasn’t doing much and added periactin to the cymbalta. After 2 weeks on the periactin I started to notice my dizziness had improved dramAtically and my head pressure was almost gone. So now I’m on both the periactin for the Dizziness and cymbalta for the anxiety. Altho both these symptoms still do exist, I am quite happy with the result so far and hope to reach 100% one day though my vision is still scewed up and has not improved at all so I’m trying to adapt to it which is not easy. So I guess in my case I can say that I.did not give pizotifen and effexor xr and flunarizine enuf time to see if they actually worked. It was only after the epilim that I started doing a lot of research and started to understand what Illness i was dealing with and what to expect from each class of medicines.

Generally doctors say that if a medicine is going to work then you shud start seeing impacts of the drug good or bad within 2 weeks after being on the full recommended dose.if the bad impact continues to gets worst, u will know that the drug is working for u in a negative way.if the good impact continues to get better than u will know that the drug is working for u in a positive way.

However there are people on this board who have noticed improvements only after 3 months of being on a certain drug. In the end it all comes down to how your body is reacting to a drug and whether u have the strength to stick out the side effects if any. Some doctors believe that if you have come accross your perfect drug that suits u, then u shud not face any side effects to begin with.however I don’t think that is correct.many people on this forum have come across their perfect drug after putting up with the side effects of that drug until it went away.

If I were u, I wud continue with the verapmil for another 2 weeks and if u still don’t notice any provement then u can decide to move on.

Cheers
NabeelNabe

I’m not an expert, but as I’m on Verapamil myself (240/day), I’d say that if you’ve been on that much for that long, you’d know if it was going to work by now. I could tell within a few weeks that it was helping (a little - the IBS got better, I stopped seeing spots out of the corner of my eye, and I felt slightly better - it takes the edge off the vertigo for me, I can tell when I’ve missed a dose). I’m thinking if you’re not noticing any differences, it might be time to try something else.

— Begin quote from "nabeel"

Hi beachgal

Generally doctors say that if a medicine is going to work then you shud start seeing impacts of the drug good or bad within 2 weeks after being on the full recommended dose.if the bad impact continues to gets worst, u will know that the drug is working for u in a negative way.if the good impact continues to get better than u will know that the drug is working for u in a positive way.

However there are people on this board who have noticed improvements only after 3 months of being on a certain drug. In the end it all comes down to how your body is reacting to a drug and whether u have the strength to stick out the side effects if any. Some doctors believe that if you have come accross your perfect drug that suits u, then u shud not face any side effects to begin with.however I don’t think that is correct.many people on this forum have come across their perfect drug after putting up with the side effects of that drug until it went away.

If I were u, I wud continue with the verapmil for another 2 weeks and if u still don’t notice any provement then u can decide to move on.

Cheers
NabeelNabe

— End quote

Thanks NabeelNabe,

Lots of insight, I appreciate you taking the time.

Thanks again,
Judy

— Begin quote from "erika"

I’m not an expert, but as I’m on Verapamil myself (240/day), I’d say that if you’ve been on that much for that long, you’d know if it was going to work by now. I could tell within a few weeks that it was helping (a little - the IBS got better, I stopped seeing spots out of the corner of my eye, and I felt slightly better - it takes the edge off the vertigo for me, I can tell when I’ve missed a dose). I’m thinking if you’re not noticing any differences, it might be time to try something else.

— End quote

Thanks Erika,

I finally got a response from my Doc and was prescribed a new med, Diamox. Dealing with side-effects from that now, so we’ll see.

Thanks again,
Judy

Glad to hear you’ve moved on to a new option. Maybe this will be the right one for you. (Don’t know much about Diamox, myself…)

Ah, I know the feeling - regarding new meds and side effects. I’m currently home because I started Amitriptyline a little over a week ago, and the whopping 5 mgs I’m on has ramped up my symptoms. (I"m starting to wonder what the point is in titrating, if we’re gonna feel worse no matter what. A therpeutic dosage of this is 10 mg, so I’m thinking, if I’m going to be stuck taking time off work, wouldn’t it be better if I was at least taking a decent dosage that might actually help, rather than keep missing time off work for a worthless dose, for several weeks before I even get to the right dose? Oi.)

— Begin quote from "erika"

Glad to hear you’ve moved on to a new option. Maybe this will be the right one for you. (Don’t know much about Diamox, myself…)

Ah, I know the feeling - regarding new meds and side effects. I’m currently home because I started Amitriptyline a little over a week ago, and the whopping 5 mgs I’m on has ramped up my symptoms. (I"m starting to wonder what the point is in titrating, if we’re gonna feel worse no matter what. A therpeutic dosage of this is 10 mg, so I’m thinking, if I’m going to be stuck taking time off work, wouldn’t it be better if I was at least taking a decent dosage that might actually help, rather than keep missing time off work for a worthless dose, for several weeks before I even get to the right dose? Oi.)

— End quote

Side-effects SUCK. I know us lab rats have to go through it, but Diamox is really doing a number on me and it sounds like Amitrypityline is doing a number on you. Since I did so well tolerating Verapamil I was able to ramp up to the full dosage in a week (instead of 3 weeks), so I tried that the other day with Diamox…big mistake. Just one extra dosage really didn’t sit well with me.

I hope the side-effects abate for you…Since I’m so new to this I don’t know if I should just stick it out or say, screw it, this drug is not for me.

Oy vey indeed
Judy

Diamox is known to have a high occurrance of side effects. In fact, at least one migraine trial of Diamox was abandoned because so many people in the trial quit taking it because the side effects were so bad.

I don’t know what the success rate for the medication is. It doesn’t tend to be a front-line med for migrane prevention, probably because of the side-effects.

— Begin quote from "JamieH"

Diamox is known to have a high occurrance of side effects. In fact, at least one migraine trial of Diamox was abandoned because so many people in the trial quit taking it because the side effects were so bad.

I don’t know what the success rate for the medication is. It doesn’t tend to be a front-line med for migrane prevention, probably because of the side-effects.

— End quote

Thanks Jamie,

I did a search on here and found the study I think you’re talking about. If I was taking 500mg off the bat there would be NO WAY. I’ve 125mg tabs and am supposed to take 2 a day for a week and then 4 a day after that. Right now I’ve decided to cut back to just one tab per day. My guess is that inter-cranial hypertension is a possibility especially because of my weight gain over the last 18 months (actually now that I think about it, it’s more like 14 months). I’ll give it a try…what the hell.

Thanks again,
Judy

— Begin quote from ____

Since I’m so new to this I don’t know if I should just stick it out or say, screw it, this drug is not for me.

— End quote

My “rule” on this is, a) can I still get to work and function there (at least most of the time)? and b) will the side effect(s) kill me, become permanent, or eventually go away? :wink:

(Of course, thus far, I’ve tried about 6 things now and haven’t managed to find one where a & b work out long enough for me to get to taking a “therapeutic” dosage for a reasonable amount of time. Stellar. Here’s to hanging in there with the Ami… :? )

Yeah I didn’t know much about the trial in question. Sounds like it was a pretty high dosage. I just saw it on a google search.

— Begin quote from "erika"

— Begin quote from ____

Since I’m so new to this I don’t know if I should just stick it out or say, screw it, this drug is not for me.

— End quote

My “rule” on this is, a) can I still get to work and function there (at least most of the time)? and b) will the side effect(s) kill me, become permanent, or eventually go away? :wink:

(Of course, thus far, I’ve tried about 6 things now and haven’t managed to find one where a & b work out long enough for me to get to taking a “therapeutic” dosage for a reasonable amount of time. Stellar. Here’s to hanging in there with the Ami… :? )

— End quote

Hi Erika,
Great rules. Thank God I only work 2 days a week now…and that’s even a struggle. I shall keep your rules in mind. Gonna email my Doc now and tell her I’m cutting back, it’s really sucky right now.

Yes, here’s to hanging in there with Ami…maybe a toast! (oh wait…ummm…can’t do alcohol…let’s just clink water bottle together :slight_smile:

— Begin quote from "JamieH"

Yeah I didn’t know much about the trial in question. Sounds like it was a pretty high dosage. I just saw it on a google search.

— End quote

Kinda wondering what the researchers were really studying. Effectiveness on MAV or migraines or the ability to tolerate horrible side-effects. I think every Doc that prescribes any of these drugs should have to take them for at least a couple days. I know the Docs mean well, but come on…500mg? :slight_smile:

Thanks as always for replying…means a lot,
Judy

Right–what is the point of the trial if they gave people a dose that basically doped them into oblivion?

Hi Beachgal,

Hope you get this since I know it’s an older post but I was wondering how the Diamox went for you. I tried it for 6 weeks and couldn’t tell a difference but the second week i was off i had a few bad episodes so idk if that’s a coincidence.

Thanks!

— Begin quote from "bandieboz"

Hi Beachgal,

Hope you get this since I know it’s an older post but I was wondering how the Diamox went for you. I tried it for 6 weeks and couldn’t tell a difference but the second week i was off i had a few bad episodes so idk if that’s a coincidence.

Thanks!

— End quote

Hi Bandieboz,

Wow, this is wild. I haven’t been on the forum for quite some time and was planning on putting an update post on here today. I didn’t stay on the Diamox all that long and have kinda played with it on and off for the past few months. I did have a Lumbar Puncture and my pressure was the very top of normal (and depending on the chart above normal). I had started back on it, but was in a work environment that was very, very hot and stopped taking it because I felt like I was so dehydrated. At my worst with MAV I was functioning at 10% and now I’m at about 85% so it’s really about tweaking stuff to get to as close to 100% as possible.
To comment on your second sentence, I don’t think there’s anything coincidental when it comes to MAV. :wink:

I followed your story closely. I am so happy for you!!!