Taking a break from meds?

So it’s been about 8 months of living with MAV, the last 5 of which I feel have been heavily exacerbated by trialling a bunch of medications that were failures (all in the antidepressant category, as I suffer from anxiety too). Each failed medication is a whole additional ordeal on top of the MAV, both emotionally and physically. And though I am not feeling well without anything I am wondering if I should just stop the trialling for a while and take a break from meds. I’m especially conflicted because I’m getting married in 2 months and on the one hand I keep thinking, what if I’m just a pill away from feeling better, while on the other, I just don’t know if I can handle the emotional windfall of another one that doesn’t work… and though I may not be feeling great on my wedding day at least I know I won’t be feeling worse from medication side effects if I stay off meds until after the wedding. It’s so difficult feeling like I’m in total control over this decision (because all the doctors seem so indifferent) so I guess that’s why I’m coming here for some moral support/your thoughts. Please share.

I was where you are once after a horrible Topamax experience. I stopped all meds and supplements for a while so I could get “clean” and start fresh. Which specific meds have you tried so far? Do you have any depression issues or just anxiety on top of MAV?

I guess I do have depression issues in that I’m prone to it in prolonged periods of stress, so yes, I am definitely depressed now. I’ve tried effexor, nortriptyline, celexa and cymbalta. All made me feel worse to some degree. I was on Zoloft when the MAV started and have considered going back to it because I was on it for a long time without a problem (and it helped to control my anxiety/depression to a certain degree), but I’m afraid of that too now after being off it for all these months and having had such a difficult time with the other antidepressant medications I tried. How long did you stop meds and supplements after the Topamax? Do you feel it was a good decision?

I don’t remember exactly how long I went without any meds or supplements. I think it was a few months. I did it because I was very angry at the time that as sick as I was, it was a med (Topamax) that almost made me housebound. I fought through the symptoms to keep working and living my life the best I could both before and after the Topamax, but the Topamax nearly took me out of the game.

My advice to you, take it for what it’s worth :wink:, is to go back on the Zoloft for the anti-depressant and anti-anxiety benefits. I’m taking Zoloft. I don’t think it really does anything for my migraine symptoms, but I do get an energy and mood lift. This helps with coping and attitude, which are critical components to getting better. Stick with that for now, along with supplements if you choose, and focus on your wedding. After the wedding and the Zoloft titration, you can consider other med options. I personally found some relief from a low dose of Zonegran, which is an antiseizure med.

Also, the #1 thing that improves my symptoms more than any med or supplement is a low-carb diet. If you haven’t tried it and are game to do so, I recommend a two-week trial of the Atkins Induction phase. You will know within that time whether it works for you or not.

Good luck. I really hope you can find relief so you can enjoy your wedding to the fullest. I’m open to more questions if you have them.

So on your advice (along with several others), I started the Zoloft at a tiny dose (12.5 mg). Unbelievably, I feel like my anxiety has exponentially increased over the last 4 days. I mean, it was bad before, but now I’m like trembling/heart racing/cannot function until I take klonopin. I am so desperate for some relief from the anxiety/depression at least and don’t want to give up on another med so soon. It’s just hard to believe that this medication, which I had no problem with in the past, is doing this to me at such a low dose. I know you’re not an expert on this but I feel like our opinions are just as valid as most doctors – so just wondering, do you think I should stick it out?


If you were able to handle Zoloft previously it seems logical that your body should be able to handle it again. With migraine though everything can be exaggerated. I also had a bad time on Zoloft but that was always the case for me. Can you cut the start-up dose in half to ease into it more slowly?

Good luck … Scott

I suggest sticking it out. I’m basing this on two things: 1. You had success with it before. 2. I had anxiety issues with Zoloft when I took it for a short while years ago. This time around, I stuck with it and have found it now eases my anxiety.

Med trials can be very difficult. I have stuck some out and the side effects eased; I’ve quit some after a short trial because I couldn’t stand the side effects; and I’ve stuck some out only to quit later because the benefits never outweighed the side effects. If you’re not miserable out of your mind, give it at least a few weeks and then reassess.

I’m not a doctor, so take this for what it is - advice based on the personal experience of another patient, but if the anxiety from the Zoloft ends up being too much for you, you could check into Wellbutrin. I took it for years prior to the start of my MAV and never had ANY side effects. It was a much more subtle drug for me than Zoloft. At this point, I like the kick Zoloft gives me, but I found Wellbutrin to be a better overall anti-depressant/anti-anxiety med for me before the MAV came along. Of course, our bodies react differently and there are those who do not like Wellbutrin. However, those I know personally who have taken it have had similar experiences as me. Note: It did nothing to help my migraine symptoms. I was actually taking it when this all started.

Bottom line: If you can stick it out, I wouldn’t bail on the Zoloft too quickly. Give your body a chance to adjust. If it gets to be too much, reevaluate your options. Good luck!