Pineal Cyst

I was just diagnosed with a Pineal cyst measuring 18mm x 8mm as an incidental find on an MRI w/o contrast. There were no other abnormal findings other than a slightly large fluid reservoir (something about the septum was mentioned in regards to this), but that it was still not large enough to be concerned about. The gland was certainly pressing to some degree on this fluid reservoir, but not to the point that the flow was being fully blocked. The cysts are fluid filled and present benign.
My symptoms going in were: constant headache since Nov 2008 (daily just varying in severity), occasional light-headedness, poor memory, constant fatigue, occasional and increasing in frequency migraines, and depression. I was diagnosed with General and Social Anxiety Disorder in 2003 and have been on several different meds the last of which has been Effexor XR 225mg since 05. Tried Lunesta for the fatigue but did not help me sleep better, just faster.
The neurologist has started me on Topamax building to 100mg after 4 weeks to hopefully stop the migraines from coming.
Is this really the best I can hope for in a treatment? Do I really have a lifetime of fatigue ahead of me?