Meds dilemma - change or stick it out

I’ve been taking metoprolol (beta blocker) since late january (dx in Jan 10, full-on symptomatic since Oct 09, possible “hints” for symptoms for about 1 year before), and it has helped, but I would say at my best I’m only 80% ‘normal’, and most days it’s in the 60-70% range (pre meds I would say I was less than 50%). I’m still symptomatic every day to some degree (mostly tinnitus, visual disturbance and brain fog, with some breakthrough disequilibrium, although the feverfew takes care of the previously rampant nausea very nicely).

So I’m wondering if I should try another med (a proper trial, not the 3 days I managed on “stupor-max” (topamax) or the 2 days on ami) or just stick it out with this one (the “enemy” I know so to speak). Should I be happy with 60-70%, or is it reasonable to look for a better result from a different med?

I’ve had a bad few weeks so have had to up the metoprolol back to 50mg twice a day (got down as far as 25mg 2x a day) to try and get things under better control, which has bought on this self-review. SO now I’m feeling sluggish, wrung out and “enjoying” the nightmares again NOT :evil:

I’d be grateful for any thoughts from those of you that have been more on the medications merry-go-round than I have. Is it worth revisiting the neuro (not a headache specialist) / seeing a neurootologist or just working with my GP given all the things I’ve learned from here and from my reading ?


Baloh would tell you that if you find a med that decreases this nightmare by 50%, you’re doing very well. However, some find meds that stop all of it so I can understand wanting to look at other options. Is there any reason you can see that has brought on the worsening symptoms over the last few weeks? Is it strictly because you lowered the dose? Just thinking there may be other lifestyle changes you could make that would aloow you to stay at 2x 25 mg daily. What about throwing in the supplements that are known to be effective such as B2, CoQ10 etc?

Cheers … Scott

Hi Scott,

I can’t track anything in particular that made things go off the scale unless it was hormonal (which I can’t control). I haven’t identified any food triggers other than red wine, which I have (reluctantly!) given up. I don’t eat MSG or any of the “big nasties”. I’d been on the lower dose for a few weeks and thought I was managing OK (certainly noticed an increase in symptoms but was “getting by”. I’m the fittest I’ve ever been thanks to all the exercise, so that’s OK. Weather wise there wans’t a big storm or pressure change that I know of - that actually happened today and I’ve been mostly OK.

I’m taking B2/feverfew and magnesium per the few reported trials (albeit the lower B2 dose that seemed effective in trials). I thought about CoQ10, but given that it’s a blood thinner and so is feverfew I was a bit concerned about taking both. Very reluctant to give up the feverfew as I am really enjoying a life with almost no nausea.

Are there any other supplements worth trying do you think?

I can only speak for myself when I say that I think it’s good to keep pushing for “better”. 50% sounds so depressing to me, and even at 75%, which I am currently having, I still crave normalcy. I don’t want to give up!!
I think you definitely could add something to your arsenal to get better, unless you’re too against meds. As for supplements, I’m not sure, based on the symtoms you are having. Have you seen the flowchart at Dr. Hain’s website?
He frequently rx’s dual meds from different groups. I think a beta blocker and an antidepressant is a pretty standard combo.
Here’s hoping you keep reaching for “better”!!

Hi Kelley,

Thanks - it does feel a bit too early to settle for 50%. I’ve seen the flow chart but might check it out again. I have no real aversion to becoming a pill-popping junkie if the pills help LOL

— Begin quote from “rockyksmom”

Have you seen the flowchart at Dr. Hain’s website?

— End quote

Website? Anyone got a link to this?


and the flowchart is