Topamax liked by hain?

hi y’all. im new. a lot of really great information here. i found a link to here from the neuro site at johns hopkins. anyway, i gotta question i hope someone can help with. i read a post here where someone said that dr. hain uses topamax first, then effexor if it doesn’t work and that he does this 80% of the time. i tried finding this information on hain’s site but only found this on his migraine page. it seems he doesn’t like topamax

Topiramate (Topamax). This anticonvulstant drug has a large number of pharmacological effects including enhancement of GABA, inhibition of glutamate receptors, sodium channels, and calcium channels. It also has a weak inhibition of carbonic anhydrase. Unlike most headache prevention medications, Topiramate often promotes weight loss. Typical doses are 25mg/day to 80 mg/d. Topiramate is expensive and has peculiar cognitive effects. The author of this review has never encountered a patient willing to tolerate its side effects.

also on that page he doesn’t even mention effexor. he mentions verapamil, elavil and others. i’m just wondering if he somehow changed his mind on these drugs or if he has updated the site somewhere else and im gettn an old page? here is a link to his migraine page that i could find. some of the pages to his site that other posters linked to dont work now. thanks in advance

-k … RAIN6.html

That’s an interesting quote. On the page you cited, you’ll see a link at the top to go to for a updated page. He says “this page is no longer being updated” When I first went to his site I was eventually able to find his updated page, but i don’t have my hands on it right now. Here’s what I can tell you.

I emailed him within the last couple of months. He told me that 80% of his practice was Topamax and Effexor; the rest of his practice was verapamil and propranolol. He occasionally uses Neurontin. He doesn’t find much effect with Lyrica or Keppra. He called TCAs messy. He did not tell me which drug he uses first. I imagine that would depend on the presentation of the patient. Within the last couple of months I can remember two Hain patients effectively treated with Effexor. I have no idea if that was their first trial.

Not sure if that clarifies - if I have time to get my hands on his most updated website, i’ll post it here, but i know others here may beat me to it :slight_smile:


thanks julie! do u happen to know if it is ok to take motrin or advil while taking topamax? i am getting different answers from different people. my doctor tells me it’s ok only once, one day a week. a friend of mine who takes it says he takes motrin whenever he needs. i can’t find any interactions on google with it and two pharmacists say it is ok. any ideas?


I use to look up drug interactions and contraindications and don’t see one between NSAIDs and Topamax. However, Topamax is real hard on the kidneys, as if ibuprofen. Could that be the reason he told you no NSAIDs? Maybe you should ask him.

You were told to drink lots of water, right?

BTW, how long have you been on it and how long are you doing?


oh that could be it! not sure but that could be it. i’ll have to ask. yeah, i am drinking a ton of water, and taking some magnesium. i have a really hard time with meds, and i have so far only taken 1/4 of the 25mg pill and have taken it only 2 times so far. and i did feel effects from it so i know i gotta go slow. he wants me on 25mg twice per day if i can get there. if no improvement, he wants me to 25mg in morning and 75mg before bed but i dont know if i can get there. i heard that u have to try and do the trial right or u wont know if it works. gotta work through the side effects. i hope it works. i really am not doing well. i have had symptoms for about 5 months now but took a while to get diagnosed. this is my first shot at doing something about it. :frowning:


You are taking 1/4 of that 25 mg tablet? You know, i’ve heard others say they can’t break those pills because the taste is impossible to tolerate, even gulping it down with water. Have you had that problem with taste? So even with that low dose you’re feeling what SEs - like what?

I know what you mean about being med sensitive. I had to cut the smallest dose of Zoloft into 8ths !! and still had SEs, but they did go away.

If you look at that website: and visit their forum, you’ll find lots of stories about what it’s like to titrate up on ACs. Epileptics are used to the SEs and they know they go away once they hit their right dose.

Just wondering - I’ve got an Rx for Topamax in my hands, but I’m holding off on taking it until i see what my Synthroid does for me.

Oh, another thing about Topamax, did you know that it can inhibit sweating? If it does, and i guess it’s not that uncommon, you need to not let yourself get hot - I’m not sure how that’s supposed to work, but that’s what I’ve read.

Keep going slow,


u got it :wink:


oh i forgot, it makes water taste terrible. i heard that it makes coke taste terrible, but i dont drink it n e way :wink: the pill is so small that i have no problem swallowing that little bit. i use a pill cutter and carefully cut it in 4’s. i started with the 2 smallest pieces and now i am on the last 2 pieces of this pill. they are a little larger than the others. its hard to make it perfect but i get close haha


i just found the new page on hains site! he lists topamax as the most effective drug for mav, but it can cause severe depression in some people, but those people were also on effexor at the same time. he says it takes up to 3 months to start working, so the trial is long. that stinks, but at least i found a quote from him saying he likes it. he lists effexor as the best one for “visual dependence” as he calls it. i think its also called “grocery store syndrome” lol or somethin crazy like that. i have that bad. very bad visual problems from this. i wonder if effexor would be better for me. i hate to second guess it now :frowning:


I just read the same information on Hain’s site. I think I am going to ask my neuro to prescribe Topamax when I see him next week. I am currently taking Verapamil, which has helped some with the vertigo and related nausea, but not my other symptoms. My headaches are actually worse, which could be the medicine and/or the weather change. I am still on a low dose and have only been taking it for a few months. However, I’m thinking Topamax may be the way to go since Hain uses it first. Any advice?

Is there anyone here who has tried Topamax and or Effexor with negative results…or have they all been positive?


the only advice i can give is to give your med a fair trial before asking your doc to switch. It just muddies the waters and you’ll never know what is working and what is not. hopefully, your doctor will know when it’s time to switch, or add, but it does help to be able to quote Hain. If you think he’s not educated enough, bring in the emedicine article by Hain that is posted on this website.


What do you think is a fair amount of time when experimenting with a new medication? One month? Years back when i was in worse shape…when prescribed some of the SSRI’s…there were a couple that i could not handle more than a week or two. I turned into a total zombie and felt lousy…plus other personal side affects. Maybe one month would be fair?


dr. hain says on his site that u need to give topamax 3 months to work :frowning: thats a long time to invest in one med. i think i read that usually it is 1-2 months per med but i might be wrong. and i guess it depends on how u do on it.

here’s a question for n e one who wants to answer. prolly most meds are gonna cause some side-effects and most get better as u continue to take the med, but when is it time to call it quits because the side-effects are too much? how long should u wait to see if they go away? a week or two? more?


Yea, Kristen,

Hain says Topamax 3 months, BBs (prop) 1 month, CCBs (verap) 2 weeks and he doesn’t talk about the time line for ADs, but for depression, you need to allow one month.

But does that mean, 3 months once you’ve reached your optimum dose? Or 3 months from the time you started the dose he prescribed? (since I never do, I always start lower) I don’t know.

About the SSRIs - those are real hard to titrate and the only way I did it was cut the Zoloft into 8ths and let it stabilize for a week. even at that slow rate I felt improvement within the first week. So you may have been able to do it if you had started at a lower dose - i was actually hallucinating at the rate my doc wanted me to go up. I cut back, took it slow and I’m at optimum dose for me now.

When to bail out - good question, who knows. When I started having arrhythmias, I knew it was time to go down on Neurontin. When I was having hallucinations, I knew it was time to back off on the Zoloft. I’ll let you know, if i ever start Topamax, what it takes to make me quit that med.

Take a look at: Those people need their meds in order to not be seizing or bipolaring or killing themselves - so they stick it out, expect, and are used to going through titrations. Read their website and take a look at their forum. Interesting.