I’ve read conflicting info on topamax. Some say you have to split the dose up and take half in the AM and half in the PM. Others say you can take it all at once (like in the PM). Also, I’ve read some say the max migraine dose is 100mg/day and others say 200mg/day. What do you guys say?
I don’t think there’s a right or wrong with this - some docs start you off with one set of recommendations, other docs start you off with another. But most docs will veer off from their original plan if it’s not working for you.
Your history with other meds, any other medical conditions you might have, and the doc’s length of experience with the drug may all figure in too.
You don’t “have to” split the dose, but if your doc recommends that, he or she may have a reason and you can ask what that is. There isn’t a max of 100 - some people get relief at less than that and some need more. I got the best dizziness control at 200 but had too much trouble with side effects at 200 mg, so I’m back down at 150 (for now - I have tried 150 one night and 100 the next, for an “average” of 125 per my doc’s suggestion, but I had more breakthrough dizziness with that regimen; however I felt a little sharper mentally, so I might try it again one of these days).
I split my dose between am and pm. I was told to do it this way to minimize side effects and to keep the levels of the medicine equal in my system throughout the day. I found that it was pretty sedating at first, so it was helpful to split the dose.
I’m currently at 100 mg–50 mg in the morning and 50 mg at night. My neurologist told me that the literature suggests that the maximum dose shown to be beneficial for migraine is 200 mg a day, meaning that above that daily dose there would be little benefit according to the studies. So given that, he would not likely put me over 200 mg if needed. But I’m doing very well at 100 mg. I’m also on 10 mg Prozac, and tapering down off that med.
I have found that my side effects (tingling feet and hands and increased dizziness) have gone away now that I’m at 100 mg. I sometimes feel like I struggle to find a word, but don’t feel “dopamaxed” at all.
It can be a tough med at first though, so I do suggest taking your first dose at night and see how you feel. At first, it helped me sleep very well!
I’m currently on 60mg per day (30 in the morning and 30mg at night). I split the dose the keep the level of the drug more constant and ‘evenly spread’ throughout a 24hr period. I think I’ll soon increase to 70mg per day, and will probably take 40mg at night, and 30mg in the morning (I use a combination of 25mg and 15mg capsules). I certainly don’t think that 100mg is the maximum migraine dose, since I’ve read about plently of people finding relief at doses between 100 and 200mg. Best wishes,