Migraines+DS+Topamax?
Duodenal Switch 08/09/06 - Dr. Paul Kemmeter, Grand Rapids, Michigan
HW: 282 - 5'4"
SW: 268
GW: 135
CW: 125
As an aside, Topamax kills your B12 and Folate levels. Shouldn't be an issue as you supplement with those already as a DSer, but you may need to keep an eye on it just to make sure.
And if you can get Botox again, do it! As a scientist I was highly skeptical, but it has made a world of difference in my life and I'm now attempting to taper off my Topamax cuz I just hate the cognitive side effects. My insurance actually fully covers it as it is now FDA approved for migraines...
Good luck and I hope you get some relief!
HW: 280; SW: 255; GW1: 150; CW: 155.
I had figured that'd be my next course of action, but as I mentioned in one response, I think I'm going to try being faithful to the hormone cream I'd been using for a month, and see how many migraines I get, before going the Topamax route. I've already filled the script, so it will be waiting for me if I need it.
Duodenal Switch 08/09/06 - Dr. Paul Kemmeter, Grand Rapids, Michigan
HW: 282 - 5'4"
SW: 268
GW: 135
CW: 125
My neurologist does the Botox and he has found that every 10 weeks is ideal to keep the migraines at bay. For me, it took about 10 days to get full relief (the toxin takes a few days to do its thing) and I noticed the migraines return after 11ish weeks and were back at full force by week 12. I waited too long between appointments because I'm an idiot, but given my background, I wanted to do an experiment and see how long it really lasts! It's quite amazing and I've gone from a chronic daily headache to maybe one every 6 weeks and it has the pleasant side effect of wrinkle elimination. :)
My migraines are also hormone related as they become super intense right around my period. My neurologist thought my BC was contributing to them so I went off of the BC for 3 months and nearly died as I had horrible migraines when I was ovulating and when I had my period...so basically almost the entire month. I obviously need oral hormones to keep my menstrual migraines in check and I now take Seasonique, that BC that you only get your period 4 times a year, so I can eliminate hormone fluctuations. It's possible that hormone cream may indeed solve your problems and you can avoid the Topamax.
HW: 280; SW: 255; GW1: 150; CW: 155.
Topamax does block vitamin A absorbtion but never heard folate or b12.
As to the vit A...my A is also in the top part of the range. And I take the topamax at the same time I take the A. So it may be a case of YMMV on some of this.
Liz
Duodenal Switch (Lap) 01-24-11 | Surgeon: Stephen Boyce | High weight: 250 in 2002 | Surgery weight: 203 | Lowest weight: 121 | Current weight: 135 | Goal weight: 135
As an aside, I know that Topamax now has a warning (though I don't think it has reached "black box" status yet) that women of childbearing years are highly encouraged on birth control if they are on the med as it has been associated with birth defects. When I asked my neurologist if that was because it affects the folate levels and therefore leads to neural tube defects, he said that was the most likely cause, but no formal studies had been done yet.
Here's the abstract of the study and I can provide the full article if you are interested!
Ann Neurol. 2011 Feb;69(2):352-9. doi: 10.1002/ana.22229. Epub 2011 Jan 19.
Antiepileptic drugs interact with folate and vitamin B12 serum levels.
Linnebank M, Moskau S, Semmler A, Widman G, Stoffel-Wagner B, Weller M, Elger CE.Source
Department of Neurology, University Hospital Zurich, Switzerland. [email protected]
Abstract
OBJECTIVE:
Antiepileptic drugs (AEDs) are important for the treatment of epilepsy, psychiatric diseases, and pain syndromes. Small studies have suggested that AED treatment reduces serum levels of folate and vitamin B12.
METHODS:
This prospective monocenter study aimed at testing the hypothesis that AED treatment is associated with folate and vitamin B12 serum levels in a large population. A total of 2730 AED-treated and 170 untreated patients with epilepsy and 200 healthy individuals were enrolled.
RESULTS:
Treatment with carbamazepine, gabapentin, oxcarbazepine, phenytoin, primidone, or valproate was associated with lower mean serum folate levels or with a higher frequency of folate levels below the reference range in comparison with the entire group of patients, untreated patients, or controls. Treatment with phenobarbital, pregabalin, primidone, or topiramate was associated with lower vitamin B12 levels compared with the entire group of patients. Vitamin B12 serum levels were higher in patients treated with valproate compared with the entire group of patients, untreated patients, and healthy controls. Folate or vitamin B12 levels below the reference range were associated with higher mean corpuscular volume (MCV) and higher homocysteine plasma levels. Vitamin substitution for 3 months in 141 patients with folate or vitamin B12 levels below the reference range yielded normal vitamin levels in 95% of the supplemented patients and reduced MCV and homocysteine plasma levels.
INTERPRETATION:
Treatment with most of the commonly used AEDs is associated with reduced folate or vitamin B12 serum levels and is a risk factor for hyperhomocysteinemia. Oral substitution is effective to restore vitamin, MCV, and homocysteine levels.
HW: 280; SW: 255; GW1: 150; CW: 155.
In the grand scheme of those type meds, it has very little "fuzzy" effect...compared to many others. I am far less fuzzy on Topamax than I ever was on meds like Neurontin, and some of the others they tried on me.
I'll probably take Topamax the rest of my life as it keeps the pain in control.
Liz
Duodenal Switch (Lap) 01-24-11 | Surgeon: Stephen Boyce | High weight: 250 in 2002 | Surgery weight: 203 | Lowest weight: 121 | Current weight: 135 | Goal weight: 135
I've been on topomax for about 5 years...prior to that I had migraines several times a month that lasted days at a time that were so painful that I could do nothing but cry and try and sleep them away.
I have now titrated up to 150mg twice a day and have about two migraines a month that require Imitrex shots to control... and will need to go to the ER about 3-4 times a year .... A major decrease from what was. Though my migraines come from a family history and not hormones, I am glad from what ever relief I get.
Side effects for me include the tingling if i miss doses and need to restart .... huge problems with word finding and when in an attach... talking... hate sounding like an idiot... never was able to lose weight with topomax....but never gained either ...so no hard feelings either way.
Overall my quality of life is much improved with the topomax, I'd be so afraid to try and titrate down my dosage... only because of the pain associated with the severe migraines... when I've had to take topomax, imitrex, and lorcet to control migraine pain... I'd rather stay at know levels than mess with sucess....
Best of luck....I know it's difficult, but I would rather deal with the side effects (even as a teacher myself... I explained to my supervisor and parents I worked with ...as needed ... what was causing the verbal mishaps while adjusting....I did find while the word stuff doesnt go away, it does settle after the initial dosage adjustment.... and for me I have problems speaking when I get the migraines themselves anyway.) We all so vary.
Take Care
Chellie