Topamax + Gabapentin?

Hi Guys
Has anyone taken these two meds together? I’m also taking Dothep (a tricyclic) which has stopped headaches & Topamax (87.5mg) to control balance, motion/visual vertigo issues. Although the Topa has helped considerably with balance & some visual stuff the car travel as a passenger is no better - I get very nauseous/anxious & can hardly walk at the end of the journey. I take Ativan which helps but is not a ‘long term’ solution. Driving myself is absolutely fine but get too tired to do more than 100kms. So have been wondering whether Gabapentin works on the same areas of the brain as the Ativan and whether adding Gabapentin to the Topamax could be an option. The other solution, of course, would be to continue taking the Ativan for every journey I need to make as a passenger (say once a fortnight - possibly once a week). Whether this would increase the likelihood of becoming addicted or my doctor becoming reluctant to prescribe them I don’t know.

I’m reluctant to come off the Topamax without having something else in mind that might have a good chance of helping. I know we’re supposed to give the med 3-4 months at the theurapeutic dose to really see if it’s working but surely I’d see some benefit on the travel by now. Today, I was only in the car as a passenger for about 10mins - totally relaxed not thinking ‘dizzy’ thoughts when ‘out of the blue’ it all descended - nausea, anxiety, dizziness, etc. Falling over when I got out of the car. Is obsessiveness a side-effect of MAV?? :frowning:

Hi Barb

I haven’t taken them together but I know it is possible because Dr Silver initially prescribed gabapentin for sleep improvement and then a list of med options to go alongside it and second on his list was topamax. They are both anticonvulsants though.

You asked if obsessiveness is a symptom of MAV and I think it can be especially if you have low serotonin as that can cause repetitive thoughts and obsessiveness I think x

I think you can take them together. Am I understanding this right- so if YOU drive- you are totally fine when you get out of the car? But when someone else drives is when you have the issue? How much does ativan help? Honestly I would talk to your dr.- if it really helps- why not just take it?

As far as overall balance, what % do you think topamax got you to? can you go up on the dose more? What % are you now if you don’t drive at all?

Yeah, I have been on these together. Everyone’s situation is different, and while they are from the same drug class, it’s not necessarily taboo to prescribe them together.

Do you feel like you are becoming addicted to the Ativan? If not, and if it helps, have a frank discussion with your doctor and decide between the two of you whether or not to just use that or to move on to something else. Using a single Ativan a few times per month seems like a pretty low likelihood of both addiction and dependence unless you have some major propensity towards it.

Thanks for your replies. I would rather not add yet another med to the ones I’m already taking if at all possible! Before all this MAV started the most I’d take would be a migraine abortive for my monthly agonising headaches, when absolutely necessary or a couple of Panadol. Tried Pizotofen many years ago & felt like a zombie so it’s been a big leap to take these powerful meds, and I’m sure many of you will have felt the same. However, when your life is ‘down the gurgler’ we find that we’ll do/try anything to get our ‘normal’ life back!

It seems so weird that when I’m driving I’m absolutely OK - but as a passenger, as soon as the car is in motion, I feel extremely nauseous & dizzy & have terrible balance problems when I get out of the car which last for the rest of the day until I sleep it off. I will ask my neuro, Dr Granot, if he has any solution - just wanted to wait until I have reached 100mg on the Topamax until I do. As I said, Topamax has helped so much in other balance/visual vertigo areas I don’t want to come off it.

I’m not worried about becoming addicted to the Ativan - just that some docs are wary about prescribing benzos on a long term basis & looks as though this symptom is going to hang around for quite a while. Thanks for letting me know that Gabapentin could be used with Topamax - it may not help with the motion issue, of course. Just looking a options.
Thanks again