I have a Neurology appointment tomorrow. Last time the neurologist wasn’t as helpful as previously and basically told me that the four medications approved for migraine were Sodium Valproate, (no thanks) Amitriptyline, (couldn’t tolerate) Propranolol (made me slow and fatigued) and Topiramate (gave me ear trouble)! Despite the fact that she did allow me to try Zonisamide (gave me ear trouble) before.
Anyway, because of this very unextensive (is that even a word) choice I decided to try Topiramate again, but I have still only managed to get up to 12.5mg daily, at which she will probably laugh. I also take 20mg a day of Citalopram and 5mg of Diazepam.
My GP has been far more helpful. I told him I had done some research and wanted to try lamotrigine which he was willing to let me try, however then I said the other one I had been looking at was duloxetine, at which he said he would be happier to give me that. So he prescribed me duloxetine (Cymbalta) but I haven’t had the nerve to stop the Citalopram and try it yet. He agreed that lamotrigine could be a second line treatment.
However, now faced with the neurology appointment I am unsure what approach to use. She previously dismissed Venlafaxine as something that wouldn’t help (when I told her about my failed trial) and she said lamotrigine wouldn’t help either. What do you think? Do I just fob her off and say I will try to get higher on the topiramate and continue to work with my GP or present her with my research on lamotrigine? My concern is that she might write to him and tell him not to give it to me.
Sorry about this post, I am frustrated that 1) I haven’t had the courage to stop the Citalopram so I could try the duloxetine and 2) that my neurologist seems very unaware of all of the different medications that are actually being used for this condition.
The thing is I am having a lot of problems with dizziness and lightheadedness at the moment, so I clearly do need some help. But also anxiety which is a newer thing for me. In fact some days the agitation is so bad I just don’t know what to do with my self, and other days I can barely stay awake. This is not going down well at work.
My neurologist (who at first I thought was wonderful) seems to see things as so black and white, i.e. antidepressants are for the anxiety, something else is for the dizziness etc but doesn’t see that there is an overlap in what treats what.
Does anyone have anything to say? If not, thanks for listening.