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http://www.clusterheadaches.com/cgi-bin/yabb2/YaBB.pl Cluster Headache Help and Support >> Medications, Treatments, Therapies >> what to do with Topamax http://www.clusterheadaches.com/cgi-bin/yabb2/YaBB.pl?num=1293990760 Message started by Mike Bernardo on Jan 2^nd, 2011 at 12:52pm

Title: what to do with Topamax
Post by Mike Bernardo on Jan 2^nd, 2011 at 12:52pm

I'm up to 150mg while in this cycle. The doc said I may go to 200mg (100 am, 100pm). I have been mostly PF for about a week, but some shadows, and a few sharp pains intermittently. 2 questions: first is, should I go to 200 mg and just bang out the headache (with a call to the neuro first, of course), and the second is, how long after the pain stops, roughly, do I start tapering the topamax? This cycle is much different than last year so I'm not sure how to handle, as last year I was on Topamax for 5 months, and the HA ended in March, it was definitely gone and I tapered. I don't want to be on Topamax another 3 months, as I'm feeling the cumulative effects of it now and want to stop as soon as possible. Thanks!!

Title: Re: what to do with Topamax
Post by Bob Johnson on Jan 2^nd, 2011 at 3:59pm

Mike, when you ask us for medical advice it suggets:
1. you don't trust your doc, or 2. you have a patient (you-since you playing "doctor") who lacks the judgment to make such a decision.

Sorry, just being a smart-ass....

Our collective experience is that a wide range of meds dosing is often required to get a handle on CH.

Patience is one of the key survival skills we all need when dealing with CH.

Title: Re: what to do with Topamax
Post by Guiseppi on Jan 2^nd, 2011 at 4:12pm

I sure wish there was a good answer to your question. Just when your cycles hit a predictable pattern, they'll totally go south on you. With lithium, my rule of thumb is 2 weeks completely pain free, I begin to taper down from 1200 mg a day. By the time I'm at 600, I know if the cycle is over or not.

It's equal parts experience, working with your doc, patience, and a boatload of luck to figure out dosing and timing. :-/

Joe

Title: Re: what to do with Topamax
Post by Mike Bernardo on Jan 2^nd, 2011 at 6:04pm

Thanks, all. My doc has been very competent. Part of my opinion of him has come from his willingness to listen to my opinions and I have had great experiences with you all. I believe that my fellow "sufferers" are my best teachers and advisors on this, so I am really hoping to get some good judgment to make my decision. 2 weeks sounds fairly reasonable. Based on my HA today, I'm thinking I'm not out of the woods yet. Depending on how the next 7 days goes, I may call him to up to 200mg, try that for a few weeks to see if it kills the cycle for good.

Title: Re: what to do with Topamax
Post by Guiseppi on Jan 2^nd, 2011 at 6:10pm

Crossing my fingers for ya Mike.

Joe