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200mg Topiramate for Migraines not enough?

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Hello everyone,

I have some pretty bad migraines and I have had them for days in a row with the throbbing, nausea, auras, light flashes, throwing up etc. I use Imitrex and that occasionally helps getting rid of them but not always.

Since about July last year my doctor put me on Topamax, I use Topiramate which is the generic and is more affordable. It started out a bit creepy with the side effects. Tingly hands and feet, weird taste, some weight loss but all that is mostly gone now. The migraines diminished greatly and I felt great. We build it up slowly from 25mg to 200 and that's what I been using up until now.

The last few weeks however I noticed an increase in my migraines. I am using an iPhone app called iHeadache that logs my headaches/migraines and there is definitely an increase. Should I be asking my doctor to up the dose of the Topamax?

Did any of you Topamax / Topiramate users build up some sort of resistance and experienced more breakthrough migraines after a while?

I just went through a 5 day migraine streak so I wonder if I need to up the dose?

What do you guys think?
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replied January 21st, 2011
I built up to only 100 mg per night (Topamax/Topiramate)and that worked well and consistently for about 5 years. It nearly always held the migraines at bay. Once in a blue moon I'd start a migraine, but could head it off with a Maxalt wafer and 2 Mersndol (over the counter pain meds with coedine - better than Tylenol 3 or Empracet for pain).

You can probably google Topiramate's website as to maximum doses... I'm quite sure you can go higher than 200 mg per day, but I'd sure check with my doctor as to max daily recommended. Good luck!
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replied January 21st, 2011
HI Spoox, its me, Wyzwolfe, again. I just did a quick check and found a very similar question asked a while back about increasing dosages. I checked the links sited and they both seem to be very good.

I hope these two help to answer your question.
Currently, I'm on 200mg of topamax. I've been on topamax for almost 2 yrs. Because I was having success with it, my headache specialist increased it to 250mg several months ago. However, I started to have significant hair loss, so he decreased it back to 200mg and added another preventative med, Verapamil.


If the Topamax isn't working for you, I know there are lots of meds out there to try! Good luck!
Kelly (forwarded from Kelly by wyzwolfe)
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replied January 21st, 2011
Thanks! those links are very helpful Smile
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replied February 10th, 2011
Topirimate - migraine help side effects
HELP

I have just atrted taking 25mg of topirimate and i am having trance like episodes. tingly lips and feeling of actually not in control of my body. Its making me pretty scared to be honest, waiting on my consultant calling me back, has anyone else had this when starting this treatment for migraine?

Jill
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replied January 20th, 2012
The tingly feelings with Topitamate are normal. The lips, face, fingers and feet are normal and it will go away after a few weeks. Weird taste of some foods and sodas is common too. I wasn't able to drink any carbonated drinks for almost a year because it all tasted like metal eww.
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replied September 20th, 2019
I use Topiramate / 100mg for 6 damaged vertabrae, 3 neck, 3 thoracic, which in turn cause me blinding (not literally) migraines, but so awful that I beg God to take me home...

My neighbor suggested it because he gets them, and for four+ months, I have not had even any real pain in my neck or a migraine.

That, for me, is genuine success.
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