I have started feeling side effects immediately, the very first day after I took the first tablet of Topamax (25 mg) at bed time. I could not sleep that night and two more nights (I was taking for three times, and then quit). In the day time I felt nausea (so was not able to eat anything), and could not concentrate at all at my work (which is mathematical modeling), so that was the most frustrating for me. So, probably, I was not patient enough to continue taking Topamax - it looks that my migraines cause less harm to my work and my general existence than side effects of Topamax. Anyway, I know that Frova helps me when I have strong migraine attacks. When my headache is not severe or just starting, two tablets of Excedrin-migraine help. Hot shower and strong massage of my top back-shoulder-neck area always is very helpful. Hot sweet tea (any - black or green) with lemon also is good, especially when I feel nausea of migraine attack. So I decided not to poison myself with Topamax. However, all people are different, all migraines are different, so what does not work for me may be very helpful for you. Just try and look what happens. Don't expect too much of Topamax - it may not necessarily work... Frankly, I do not believe that there is a universal medicine from a migraine. My friend, for example, is very happy that an ordinary over-the-counter medicine Aleve relieves her migraines, and she cures her headaches with sleep. As for me, I cannot sleep with a migraine at all: pain does not let me fall asleep. But lack of sleep might trigger my migraine - I know this definitely. Unfortunately, I do not have always possibility of good quality and sufficient for my body sleep, since I must work very hard in deadline stressful pressure.