Quick question about dosages

Greetings all,

I am meeting with my Neurologist tomorrow to (hopefully) strategize my next plan of attack regarding medications.

In the past, I had been treated by a ENT physician who , according to him, was uncomfortable pushing the envelope with MAV meds in terms of dosage levels.

I think this is just a comfort issue as this is not his forte.

However, with my diagnosis from Dr. Baloh at UCLA, we are trying to throw the kitchen sink at this baby.

Below is the dosages that I have tried in the past…all to no avail:

  1. Amitryptiline - 50mg
  2. Nortryptiline - 15mg
  3. Neurontin - 300mg

Mind you, I don’t think I took any of these for over a month…as I was very skeptical of the migraine meds.

What dosages can these be ramped up to? I am a 200lb man (as you remember from Dr. Baloh’s notes…he mentioned I am “well nourished”) :lol:

Thanks much, Todd (Baloh wants me to try Topamax next up to 100 mg…just planning for the future) :smiley:

HI Todd,
Unlike alcohol, they say that the tolerance for meds has to do with how one metabolizes them…not based on size. I did a test (my chiropractor ordered it for me…called a challenge test or something of the sort where you ingest aspirin/tylenol and caffeine, and then use saliva and urine samples to see how quickly they get eliminated) that showed that I am a quick metabolizer…so I take my meds twice a day (the Cymbalta) vs. just once. I am still baffled that you aren’t seeing ANYTHING with the amounts of meds you’ve tried…
I know for Ami, and NOrt, the amount to start out with is 10mg for migraine, but 25mg for depression…the amount goes up to 150mg or so for depression, so I guess there’s quite a range. I have read Neurontin can go up to 4000mg…you basically can go up as high as you want…I wouldn’t be comfortable with that.
For Topamax, I think starting at 25mg and going up from there SLOWLY is the key…the titration with this med is especially sensitive (so I"ve heard, I haven’t tried it). It hits a lot of different things in the brain, so I"m hoping you will get some good response.

Thanks for the reply Kelley,

I agree…I would have preferred if the Celexa at least caused something (good or bad) so I know that medications can have some kind of effect on me :slight_smile:

60 mg of Celexa for a couple of months was a fair trial I believe.

As far as the other medications, I do not really believe I have been given therapeutic levels to get a true feel for whether or not the medications will work for me or not.

I am hoping (praying) that with Dr. Baloh’s diagnosis and his protege Neurologist working at the hospital that I work at, we can begin trying medications at truly effective dosages.

Baloh wants Topamax next…so when I meet tomorrow, I will hopefully be able to start that medication.

It is one that I have not tried yet.

Thanks again and keep praying for me…I need it :mrgreen: I am a realist now…i am not shooting for 100%, just hoping to catch a f####
break would be nice :smiley:
Thanks, todd


I know Steve Rauch likes to start Nori at 10 mg and titrate up to 40 mg over about 4 weeks or so. My doc said you need to give these meds at least 6 weeks at the high efficacious dose to really know if it will work. I know Kelley’s doc thinks it’s quicker but I always think of Rich’s case. He was on Topamax for 4 months before BOOM, it all stopped. 50 mg was the magic number for him and it was not easy to get there. He has not been back here for a very long time presumably because he’s well and wants to forget it all but you can read his success story above (Rich2008).


It was at least 2 and more like 3 months before I could definitely say that beta blockers were helping me