Huge difference in immediate release and sustained release?

I’m taking 160 mg of verapamil a day split up into 2x 80 mg immediate release pills when I first got on it we discussed switching to the sustained release when I got up to that dosage cause I started at 40 but I think he was concerned cause I have naturally low bp and he thought the sustained release might affect it more, last time I went in we added topamax so we were focusing on that and forgot to ask about switching over to the sustained release, do you think there is that much of a difference and has it proven more helpful with symptoms with the sustained release? Is it worth changing?

I wonder if he will want me to go up to 180 mg or down to 120 mg since im not adding the topamax

I just saw this question you posted a while back, don’t know if you’ve changed already or not… For what it’s worth, I’m on 240 Verap, (80, 3x/day) of the immediate release. I tried last week to change to the 240 XR version and that soooo did not work. (The neuro wasn’t sure how it’d go, and the pharmacist said I wouldn’t notice a difference. Right.) Within 30 minutes of taking it, my visual vertigo was TONS worse. It lasted a full 14 hours before I was back to my usual level of yuck. And I had some chest pain and some arrhythmia issues that day and the next (arrhythmia only) as well. Needless to say, you may respond differently, but be warned that it’s possible that your body will recognize a change. (Unfortunately I did this in the middle of the week so I lost a day of work - argh - I should know better than to play with new meds during the week, but I figured it’d be okay!!!) So, all that to say, I never did make the switch over. 3 times a day is it for me!