Topamax and vitamin A absorbtion - do not mix

I read earlier a post here about migraines and topamax.  It seems alot of you take the drug topamax and I do as well.  I just wanted to let you know, in case you dont know already that you can't take vitamin A and topamax within 4 hours of each other.  I found this out the hard way when I was diagnosed with vitamin A deficiency and started on 25,000 units of dry A  daily (I am RNY) well after 2 months, I got my levels checked and they didnt' improve at all so my NUT did alot of research for me as well as my neurologist and they both found that topamax blocks the absorbtion of vitamin A.  I increased my dose to 50,000 units daily and separated my vitamin A and topamax (150mg) and my levels have been great since.

I know alot of DS patients have trouble with vitamin A absorbtion, so in case this is part of of the reason, thought I would share this information with you.

 Thank you for this - I appreciate that info greatly.   I still haven't decided yet if I'm going to try the Topamax.    I filled the script, came home and read all of the feedback on it, and now I'm afraid to try it, especially with the new academic year starting, when I need my brain power the most!

Julie, I've kind of held off on adding anything about the Topamax since so many seemed to like it, but here goes my experience.

A friend and I both started Topamax about the same time, by the same Dr., for migraines.  I was actively working as a nurse at the time, my friend wasn't working.
I did have difficulty with keeping my head together and felt I was a lot "shorter" with people than normal. I quit taking it for that reason.

My friend, lost a lot of weight while taking it, personality really changed for the worse.  Her family kept trying to tell her it was really making her weird.  I finally told her one day that I just couldn't tolerate her tongue and actions anymore while on this med, so if she ever decided to get off of it, to let me know, we could resume our friendship.  Once she was off of it, her personality changed as if day/night for the better.

I'm not saying one way or the other, just my own experience.

 Oh my - this just terrifies me!     My headache hit me like a brick wall today, and I took an ultram and it feels pretty good right now, but I HATE taking any analgesics because of the rebound effect.    I always feel like I end right back up on square one when I do that.   Do you think you had any more difficulty "keeping your head together" with this than if you were taking a narcotic or narcotic-like pain reliever?   I can work pretty effectively on 25 mg of tramadol, but it doesn't take the edge off.    50 mg, I'm too fuzzy.    How are your headaches now - what are you doing to treat them?

I think I'm going to tough it out for a month, try doing the progesterone cream, get my hormones tested, and go the Botox route if I still have problems, even if it means traveling the 90 minutes that I'll have to to see a neuro doc.    I feel badly that my insurance company just paid $335 for a prescription of Topamax to sit in my cupboard, but I am a teacher in a district of very high risk students, and I need to stay on top of things every second.    

Julie, I switched to a med called Maxalt DS?? something like that.  It was wonderful because not only would it control my migraine, I was able to totally function after taking it.

I rarely have migraines anymore since I went through menopause, so when i do, I just do the Imitrex nasal spray.  Not as fond of it, but it works.

Another thing I've done, but don't know how it works with the DS, is when i first feel the migraine coming on,  I take 3 ES Tylenol and 2 Ibprofan at once and it oftens dissipates.

 Diane - the tylenol/ibuprofen combination is one, when I worked as an ER tech, that the doctors there recommended.    Three tylenol/800 mg of motrin.   It sounds like a lot, and I remember the first time the doc told me to take it, I raised my eyebrows.   He said, "Don't worry about it being too much,  you won't have to repeat the dosage."   He was right - it stopped it in its tracks.   

I tried Maxalt years ago, and found myself rebounding quite badly on it.    I keep thinking if I can just tough it out until menopause, but get this - I'm 50 and STILL have follicles on my ovaries!    My mom didn't have her final period until age 60.   Joy.

I had a partial hysterectomy in my early 30's, still had my tubes and ovaries, so just finished menopause last year.  Migraines were dissipating with the hormones.

I would try to attack them through your hormones, there is so many hormone therapies out there.   Your Endo should be able to help you out.

If you choose the Topamax route, just be aware and watch for signs and symptoms and listen to those around you.

Wish you the best on this Julie.

I used to get migraines really bad - almost every day and sometimes they lasted for 2-3 days.  I ended up in the ER atleast 2 times per month for IV pain meds and IV nausea and fluids.  IT was bad. My neurologist had to do something - the imitrex as needed just wasn't doing anything.  He decided I needed preventatives.  He put me on both Topamax and Verapamil - I started with a low dose of both and things got a little better - 4 times per week and then when I got them, I took zomig and the zomig usually worked.  Very rare ER visists after that.  HE then increased my topamax and the migraines got even better - about 2 times per week and I was very happy.  Then I had my RNY and I had my last period the day of my surgery - menopause at the age of 46,  After that, my blood pressure and pulse got dangerously low so I had to stop the verapamil.  So, he increased my topamax to my current dose of 150mg which was the best thing he could have done.  Since that increase, I hardly ever get migraines - maybe once a month.

I never had any weightloss or fogginess with the topamax.  I would never give it up and couldn't survive without it.

Maybe start with a tiny dose and work your way up - I think that is why it worked for me.  I started with the 2 medications and small doses of both and worked my way up to a higher dose.  THis way we could avoid side effects - if I get any, we could go back to the lower dose.

 My prescription notes that it starts out really small (25 mg) then works up gradually - a bit  more each week.

Julie,
  I used to take Topamax, which did help the frequency of my migraines, but it made me stupid.  I couldn't remember anything!  I'd even forget what I was saying....mid-sentence!  There was no point in telling a joke, because I'd forget the punch line!  Then my arms and legs began tingling all of the time....it was horrible!  I'm now taking Zonegran, which is still considered and anti seizure drug, but it doesn't give me all of those terrible side affects at all.  My neuro wants to slowly bump up my dose, so I started on 50mgs for a few months and then100mgs, which is what I'm at now.  With the Topamax, she thinks we titrated the dose up too quickly for me.

Also, you mentioned not liking taking pills for your migraine.  When I'm working/driving, I get a shot in the butt of Toredol, and I've had no ill effects at all....well except a sore butt cheek!  If you could get your doc to give you an Rx, your school nurse could administer the shot if you need one at work. My husband gives me mine.  The doctor instructed him on how to give the shots.  She didn't want me taking oral Toredol, in order to protect my sleeve from ulcers.  If you try the shots, DO NOT put the vials in the fridge!  Just trust me on this one!  You will think you are going to die!  Room temperature....always!  PM me if you'd like more information on what I'm doing for migraines.  Still getting them but making great strides!