Jackie,

Antidepressants such as Cymbalta are often a good addition to a Migraine prevention regimen. Of course, you won't know if it works for you until you try it.

On the Topamax dosage -- did your doctor or NP tell you to take it all at night. All the recommendations and prescribing information say to break it into two doses per day for a couple of reasons.

1) The half-life of Topamax is only 21 hours. Keeping a steady amount in your bloodstream makes it more likely to work well.

2) The incidence of side effects is reduced with split dosing.

Don't lose hope, Jackie. Even if it turns out that Topamax isn't the drug for you, there are many other options, including other medications of the same type. There are now over 100 medications and supplements that can be used for Migraine and headache prevention. The frustration of trying to find what works for us can make it seem as if we've tried it all, but with so many possible preventives, it's literally impossible to have tried them all. See Migraine preventive medications - too many options to give up! for more information.

I know you're going through a rough time. If you'd like some additional support, come join our discussion forum. You'll need to register again once there because it's a separate membership database, but you can use the same member name, email address, and password that you used here. You can find our forum at http://forums.healthcentral.com/discussion/migraine/forums.

Good luck,

Teri