Friday, December 04, 2009 Allie85 asks

Q: Topamax or Nortriptyline?

Hi everyone. I have chronic migraines and my doctor has told me I need to go on either Topamax or Nortriptyline and I'm trying to decide between the two. Initially I was tole Topamax but never started it because I was too afraid of all the potential side effects. Now he gave me Nortriptyline as another option but I dont know which is better......The side effects for both intimidate me but I am at the point where I will do pretty much anything to not have these headaches anymore. Ive heard people tend to loose weight on Topamax and gain weight on Nortriptyline?

I would really appreciate the advice!

Thanks

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Answers (8)

Nancy Harris Bonk, Health Guide

12/ 5/09 10:47pm

Hi Allie85,

Well, I hate to break it to your doctor, but there are over 100 medications available for Migraine prevention. We hear a lot about Topamax becasue it is heavily marketed to doctors and patients alike - that doesn't mean it is the best one out there. Take a look at this article, feel free to share it with your doctor: Migraine Preventive Medications - Too Many Options To Give Up!

It may be time to see a Migraine specialist, if your doctor isn't able to help you, 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

Nancy

shopgirl

12/ 5/09 12:39am

I personally take Topomax for my headaches. The only side affect that I've noticed is once I started taking higher doses, I became an insomniac. But now that I've been taking the higher dosage for a while now, the insomnia is getting a lot better. A friend of mine takes the Nortriptyline and she doesn't have any side affects at all from the medication. I hope this was helpful for you! I hope you get some relief for your headaches.

Megan Oltman, Health Guide

12/ 6/09 4:50pm

Hi Allie85 -

Nancy is right, there are tons of options for Migraine prevention. You oculd choose something else entirely!

Given the two you are looking at, of course everyone's experience is different, but I'll tell you mine. Topamax suppressed my appetite and I did lose weight on it. I also had a high degree of mental fuzziness which made it hard for me to do my work, and the Migraine suppression from it was not that great. I've been on Nortriptyline for almost 3 months now (and off the Topamax for 2 months) and I'm really liking it. I have more appetite than with the Topamax and things don't taste bad anymore, but I haven't gained any weight. It also helps me sleep and makes me much calmer and less anxious in general. Anxiety and insomnia are big issues for me and make my Migraines worse. So far it seems to be suppressing the Migraines pretty well but I think it's still early to tell.

Of course your experience may be very different, but this is what mine has been.

- Megan

Donna

2/ 3/10 4:08pm

I stopped taking topamax for the same reason of mental fuzziness, although it kept my weight down as well. I've now been on nortriptyline for a little over a month and haven't noticed many side effects at all. My concern is the weight gain though. So far I've gained about 2lbs, which I don't want to freak out, but am concerned that this could continue. I'm taking 30mg daily and from what I'm reading that's a low dose. -Donna

janaya

5/20/10 8:04pm

I have been taking Topamax for about a year now and I absolutely love it. It's like gold to me. Out of 30 days of the month I had a migraine for about 20. It was horrible. It controlled my life. It made me sleepy and that's why you're supposed to take it at night. I was ok with this because I never got a good night sleep until I started taking this medication. It never affected my job or anything else. I will say that I was hoping to loose some weight but I didn't : ( Now because of other problems my doctor wants me to try Nortriptyline and I'm scared to death because I DON'T WANT TO GAIN WEIGHT! Wish me luck.

Nicole

7/ 2/10 8:27am

Hello

I just started taking Nortriptyline to prevent almost daily migraines. I was on Topamax for 7 years and it worked really well for the first 5. I started at 25mg daily and until my doctor increased my dosage to 50mg. I loved the side-effect of weight loss but I had a very hard time with memory and felt fuzzy when taking 50 mg's. I had to search for words constantly and felt like I was dumb'd down a knotch. My doctor wanted to increase my dosage to 100 mg's daily when the medication stopped working but I refused because of the memory loss while taking 50mg's. As soon as I stopped taking Topamax, I began to think more clearly and more on top of my game but have gained 5-6 lbs in a bit over a month.

I've only been taking the Nortriptyline for 2 days and the only side-effect so far is rapid heart beating during the night along strange and vivid dreams. If this actually works and that is the only side-effect, I can definitely deal with that.

4/ 7/11 10:02pm

I was on Topamax for 2.5 months for migraines. It was a terrible drug for me - my memory was terrible (forgot very simple things and it was frustrating: how to get to work, pin code for work voicemail, loss of words, & dumb stuff like trying to put diesel in my car!). It was hard to do my job at work. It also made me very depressed. I have been on 40 mg of Nortriptyline for 10 months and it reduced my headaches drastically (especially at first). They are coming back again though and I really don't want to increase the dosage because I am afraid of gaining weight. I'm 39 121 lbs and haven't gained any yet, but am hungrier. Topamax took away my appetite after a month and made carbonated things taste terrible. Anyhow, the only main side effect I have is a very dry mouth. Give it a try. Good luck!

theisennay

2/13/12 12:21am

I am currently on topamax. I have a loss of memory. Can't remember passwords, movies that I've seen or conversations that I had just an hour ago.

It doesn't help with my migraines at all, I don't have any weight loss and it doesn't make me sleepy.

I also take verapamil to prevent. Exedrin migraine to manage. Imitrex to stop and if that doesn't work I have the imitrex shot.

This is too much! I personally am requesting to be put on nortriptyline and hopefully quit the rest of the circus.

My friend was doing the same thing that I am, she switched and hasn't had a headache since.

ADIV_23

2/22/12 12:45am

Hi there, I have never used topomax but i was on nortriptyline for 6 months. During this six month period i went up 30 pounds. Its ridiculous i can't wear half my clothes anymore and i don't have cash lying around for a new wardrobe. My entire adult life (15 to 26) my weight has been the same so it was not due to change in diet. This pill did help my migraines though, i went from headaches twice a week to maybe once a month. Other side effects i had were dry mouth, dizzy spells, tired all the time, and crazy vivid dreams. I stoped taking it a month ago and the weight is coming off pretty quickly so i am pretty sure that the nortriptyline was the culprit. I am back to migraines every week but the side effects were unpleasant enough for me that i need to find another alternative.

Q: Topamax or Nortriptyline?

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