Topamax stopped Migraines for four years. Stopped it. Now not working?

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    Hi, My daughter who is now 21yrs, six years ago she start having headache, to the point way she passes out with it, at the time she MRI and other test done, we was told my the doctor it was migraine and was put on topamax for one year and did not have a headache for four years, but lately she been having headache , one month ago she was put back on topamax 25mg, and she is still getting them .once a week badly. she is also a second years med student. the Dr told me if get very bad we might to give her some steroids, because the topermax take time to work, need help. worry mother Jenny.

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    Answer:

     

    Dear Jenny;

     

    The Topamax may or may not work for her again. It's an unfortunate finding, but if a medication is working for Migraine prevention, and the patient discontinues it, it may not work again. Only time will tell, but it's unlikely that a mere 25mg of Topamax is going to be of much use. Topamax is generally started at 25mg taken at night. A week later, it's increased to 25mg in the morning and 25mg at night. If that doesn't work, it can be increased 25mg per week up to a total of 200mg per day. If it doesn't work, the it must be tapered down in order to try something else.

     

    There are a great many medications and supplements that can be useful for Migraine prevention, over 100 of them.

     

    If her doctor isn’t able to help, it may well be time to consult a Migraine and headache specialist. It’s important to note that neurologists aren’t necessarily Migraine and headache specialists. Take a look at the article Migraine and Headache Specialists - What's So Special? If you need help finding a Migraine specialist, check our listing of Patient Recommended Migraine and Headache Specialists.

     

    Good luck,
    John Claude Krusz and Teri Robert

     

     

    To review other questions from our Ask the Clinician Column,
     browse the Ask the Clinician archives.

     

    If you need help finding a  Migraine and headache specialist,
     visit our listing of Patient Recommended Specialists.

     

     

    About Ask the Clinician:

    Dr. Krusz is a recognized expert in the fields of headache and  Migraine treatment and pain treatment. Each week, he and Lead Expert Teri Robert, team up to answer your questions about headaches and  Migraines. You can read more about Dr. Krusz or more about Teri Robert.

     

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    Last updated March 30, 2010.

     

Published On: March 30, 2010