Reason why prophylactic drugs take time to work?

ok so i have been on 100mg topamax for 2 1/2 months now and i can safely say that i have never felt better than this since i got this MAV crap 24/7 beginning of 2012. still have the daily rocking and swaying, still feel off when stressed or when sleep quality is bad, but overall compared to where u was i am feeling good. balance and disequilibrium are quite stable. just joined the gym and have been working out hard and i know the over exertion causes my rocking and swaying to increase. but i am putting up with it cz i go to the gym in the evenings and when i wake up in the morning i am back myself. but the gymming is making me feel fitter which i hope is playing a part in my overall decrease in symptoms. the actual reason for my post is that although i have been in topamax 100mg for 2 1/2 months and only just started noticing the real venefits, i dont understand why? i mean if a drug is meant to work, shouldnt the chemical u take start working almost instantly? it took me about 3 months to get to 100mg and now 2 1/2 to finally see some benefits out of it. and mind u this was my third attempt on topamax. i gave up the first two times due to sides effects but on my third attempt u persisted. so reallly the qyestion is when a tablet is inserted into your body it breaks up and gets into your blood vessels whatever its user. so why prophylactic medicines need to b taken forever?

So glad to hear you are doing well nabeel!!! what % do you think you are now? What were you before both meds? not sure why it takes so long but just enjoy it :slight_smile:

Hey Nabeel,
It’s good to hear you are doing well on Topamax. I am still fighting the awful side effects and hoping the dizziness die’s down with Topamax. I am just wondering if the Cymbalta you are taking is also helping. I know some people get off the migraine preventative and the antidepressant does them justice. I guess because anxiety makes migraine worse.


i am still hovering at 80% consistently but i can see minor signs of relief here n there which leads me to beleive that if i continue taking topamax i shud hit the 90% mark sooon. yes im stilll on the cymbalta which certainly helps with anxiety and MAV in the beginning but plan is to cut down to 90 MG after my next neuro visiy after hearing what he says. the question now is do increase my yopamax to 125mg or stick with 100mg? i emailed my neuro and he saysnu do wat u feel right. moreover my question is unaswered that is what is the reason for prophylactic drugs to takebsoblong to work?

Yes, took me 5 months to get to 100mg Topamax and then another 2mths to see good results. Apart from setback from BPPV that is! As to why the meds need that time to make changes on the brain I assume it’s just a very, very slow process like any rehab is whether to muscle tissue or brain tissue. Our brains have suffered a huge ‘jolt’ and they need to be ‘fixed’ or even new ways found to ‘connect’ all our balance pathways again. Dr Granot talked about the ‘plasticity of the brain’ and perhaps this is why it takes so long for that readjustment to be made. Just needs to be worked on every day until step by step the changes become permanent.

Nabeel - this is just my own ‘take’ on things! I have no medical knowledge whatsoever but have read a lot about the ‘plasticity of the brain’ and know that amazing changes can take place if we work hard enough on it. :roll:

I recall Dr Granot’s opinion was that going higher up on Topamax was not necessarily going to be of help for you. He has recently suggested to me that I push up to 125mg to help control my balance issues as well as adding the Cymbalta. I think I’ll trial the Cymbalta first and see how I go.

I was also reading a post of a visit to Dr S. who made a comment about treating this condition ‘aggressively
to get the migraine under control’. You seem to be following exactly that course with your exercise, meds, diet, etc. !

Nice work Nabeel. You really are persistent and it’s paying off … a good role model for Topamax and migraine treatment in general.

I don’t know why it takes so long other than to say the nervous system takes many weeks to settle down once it’s charged up long term or to this degree. Not unlike someone recovering from a nervous breakdown … which of course does not happen overnight.

What actually is a ‘nervous breakdown’? I thought it was a term used ages ago to cover all sorts of mental illnesses and
not sure quite what it means! :roll:

So no damaged ‘neural pathways’ then?