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!!

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

Crossing my fingers for ya Mike.

Joe