After dealing with migraines for close to 10 years, I have recently gone off of all prophylatic migraine meds to to a series of undesireable side effects from a series of different meds. The most effective medicine I've taken in te past year was Noritriptylene, which caused horrific nightmares that woke me up a minimum of 3 times a night, mood swings, and a 30lb weight gain (from May to September). After going through withdrawels from the Noritriptylene, I gave Topomax another try. It worked successfully for me for 5 years, until the cognitive dissorientation, blackouts and all around cognitive slowing became too much. I'm currently taking only abortive meds, and for the first time in years I can think straight and talk without fumbling over my words. The flip side is, I'm having migraines a minimum of every day. The pain is excruciating, and I'm nervous that I may be using my painkillers too much and causing rebound headaches. I'm constantly nauseaous and throw up often. I don't know wether this is really worth it. I'm in the middle of a semester, and school is extrememly important to me. My neuro mentioned Neurotin and Lamictal as other options, but I'm nervous about the cognitive side effects, and weight gain, not to mention Stephen Johnson syndrome which can accompany Lamictal. If anyone has any advice, I'm all ears.