Hey everyone I’m on 80 mg verapamil 2x a day so all together 160 and then 25 mg topamax in the morning because it was keeping me up with I was taking half at night which in turn was making my migraones worse from lack of sleep. I’d like to stay at the lowest dose possible that will work and my neurologist says I should stay on the 25mg for 2 more weeks and of its helping not to move up to 50 mg has anyone seen benefits on 25 mg? Is it too hopeful to think it might be enough in combo with the verapamil? I was hoping I could wait it out and keep taking the topamax 2x a day but I’m not getting any sleep and it’s making me crazy so I had to switch to taking it all in the morning.
Hi Chelsea,
The key is to start low and go slow as you titrate up the dose. In clinical trials 50 mg of Topamax is no different from placebo for migraine treatment. It’s not until patients hit 100 mg that the benefits were stronger than what one would expect from placebo. Of course we are all different too and you could very well have an effect on 25 or 50 mg that will suit you fine. There are people on this forum who have achieved total control at 50 mg.
My brother’s wife is on 150 mg daily and is pretty much migraine free. She reports no side effects but she does not have MAV either but more typical migraine.
So I would keep moving up until you see a an effect against the migraine or until side effects become intolerable. It can take a couple of months to see the effect from neurological stabilisers like Topamax.
Good luck
Scott 8)
Oh my gosh, Topamax makes me so tired! I was told that 100 mg was the dose to start at first and 200 mg was the top based on studies showing that is the max dose that seems effective for migraines. I was at 100 mg Topamax for six months while also on 10 mg Lexapro and moved up to 150 mg Topamax four weeks ago and am down to 5 mg Lexapro and will try to wean completely off the Lex.
Scott is right–take it slow and increase in low increments to see what might work for you. Maybe 50 mg will do the trick since you are on verapmil. It does seem like a baby dose, but it may be the right dose for you.
Good luck!
Anne
One other point is that in migraine trials Verapamil is not brilliant really unless the migraineur suffers from aura before headaches. It tends to work better for that scenario. Having said that, there are a few members here who have had good results with Verap.
Yeah I’m hoping that I can kick that side effect cause it doesn’t make me feel a little off when I take it all in the morning but I seriously havnt gotten more than 2 hours a night of sleep in 4 days and it’s killing my mental state haha so I’m hoping that will wear off cause its giving me a little anxiety and that might be what’s keeping me up so I’m hoping when I go up to 50 mg if I have to I can split it up again and take 25 in morning and 25 at night is hate to take that all at once. But I know a lot of people initially have some issues sleeping but it does pass usually.
Also to Scott I didn’t notice any improvement headache wise with the verspamil but I havnt been on it long I did notice that I wasnt as dizzy all the time as I normally am but that coulda just been a coincidence as it varies from time to time how I feel. But I figured it was worth a try and who knows it may help.
Hi there,
I went up to 200 mg of topamax without too many side effects. I kept wanting to go higher and higher as I was tolerating the med quite well and was desperate for it to work. The key to increasing is to go slow to see what your body can handle. I don’t think verapamil and topamax interact at all. I was also on verapamil at the time of my topamax trial.
Good luck!
Christine
Chelsea, I’ve been wondering the same thing. I’m on verapamil and building up on topamax, too. The verap (80 mg, 3x/day) takes the edge off things for me - got rid of the random flashes of lights I was seeing, and if my head’s really fuzzy, usually improves things just a smidge - not great, but a tad better. Though, I did notice a couple times this week when I took my morning verap, my head went from the usual not-so-great, to lousy - doesn’t usually happen that way. Was wondering if that was because of the topamax. Who knows. Oi.)
Funny, I’m having the opposite effect from the topamax - makes me sleepy, so I take it before bed. Kind of nice. Well, mostly. (I almost smothered the cat last night when I rolled over on her and didn’t notice… :shock: ) Anyhow, I usually get the insomnia side-effect from stuff, so this is a welcome change. That said, I’ve been way more fatigued this past week (2nd week on it, only on 25 mg) than I usually am. Scott, really, 100 mg for this stuff to work, huh? Ugh. I have to say, I was toying between going another week at 25 or adding in another 1/4 tab to get to 37.5 mg this weekend, but after how lousy I felt this week, heck, I’m ready to throw in the other 1/2 tab and kick it up to the full 50 mg now if I’m going to have to get to 100 to get some relief. Geez. (Other than the fatigue and my head being more “swimmy” than usual, so far no horrible side effects, but I just know the second I rush things… Oi.)
Makes me want to ask my neuro for something a bit more fast-acting! 
Christine, did the 200 mg work for you? (How long were you on it, if it didn’t? Or, how long did it take for it to work, if it did?)
Well before I was diagnosed with the MAV I was on topamax before and when I got up to 50mg all my mugraine went away except maybe 2 a month but we didt know I had MAV and so when it wasn’t helping the other symptoms I went off of it, now knowing how long it can take to get rid of the dizziness we want to retry it. Really the only side effects I’m having with the topamax is the lack of sleep which I’m reading goes awy after awhile I’m gonna try splitting it up again and taking the topamax with dinner and seeing how that works. The verapamil I thought made me feel a little better but sometimes I did feel like it made my migraines worse but who knows it coulda just been a fluke deal. So I think 50 mg can work good for some people of they are willing to wait it out but I guess people would rather go up to 100 because it’s gotten better results. I would like to stay on the lowest dose possible that’s effective though because I’m sensitive to meds usually.
Hi Erika,
I went up exceedingly slow, and since I felt it was my “last chance” I sadly wasted over a year on it. It did nothing for me despite my wanting my topamax/verapamil combo to work so badly!!!