This evaluation focuses around the use of Topamax (topiramate) for the therapy of headaches, particularly migraine headaches. Topamax was initially authorized as an anticonvulsant, but has been authorized by the FDA for use as a therapy in stopping and decreasing the frequency and severity of migraine headaches.
What's a Migraine?
Migraines can very best be described as a recurring headache with intense throbbing discomfort that's generally situated on 1 side with the head. An attack usually lasts from four to 72 hours. The following kinds of migraine headache have already been identified:
Migraine with out aura (typical migraine): This kind accounts for 80% of migraine headaches. There isn't any aura prior to a typical migraine.
Migraine with aura (classic migraine): This kind is generally preceded by an aura and is generally a lot worse than a typical migraine. Most frequently, an aura is really a visual disturbance (outlines of lights or jagged light pictures).
Standing migrainosus: This really is the term utilized to describe a long-lasting migraine that doesn't go away by itself.
Migraine headaches impact roughly 15% of individuals and more than 80% of them have members of the family who also get migraines. 3 occasions as numerous ladies as males get migraines. The precise reason for migraines remains unknown. Particular chemical substances usually discovered within the brain (namely, dopamine and serotonin) might be involved in creating migraines. These chemical substances are known as neurotransmitters simply because they transmit signals inside the brain. Neurotransmitters can trigger blood vessels to act in uncommon methods if they're present in abnormal quantities or when the blood vessels are especially delicate to them. Numerous triggers are believed to bring about migraine in individuals who've a all-natural tendency for getting migraine headaches. Various individuals might have various triggers. Typical triggers consist of foods like chocolate, cheese, nuts, alcohol, and monosodium glutamate (MSG); missing a meal; tension and tension; birth manage tablets (ladies frequently have migraines in the finish with the pill cycle. This really is known as an estrogen-withdrawal headache).
Topamax is primarily utilized as an anticonvulsant. It impacts chemical substances within the brain that assist to cut back seizure activity. It's also utilized to stop migraine headaches. Topamax will only stop migraine headaches or decrease the amount of attacks. It'll not deal with a headache that has currently begun. Sufferers taking Topamax to stop migraines usually take dosages varying in between 25 and 400mg every day.
Unwanted side effects
Typical unwanted side effects: drowsiness, dizziness, tingling sensations, loss of appetite and excess weight loss, difficulty concentrating
Unwanted side effects that ought to be reported promptly: unsteadiness, slowing or shakiness, speech issues, mental/mood modifications, stomach/abdominal discomfort.
Unlikely but report promptly: itching, difficulty or fast breathing, fast/slow/irregular heartbeat, loss of consciousness, fever, persistent sore throat.
Look for instant medical focus if any of those uncommon but extremely severe eye issues happen: sudden vision change/blurred vision, eye discomfort or redness. Infrequently can trigger decreased sweating, which could raise the body temperature (hyperthermia).
Topamax has been related with some uncommon, but severe adverse impact which includes:
-lowering of bicarbonate ranges within the blood - Measurement of baseline and periodic serum bicarbonate is suggested.
-Acute myopia and secondary angle-closure glaucoma - sufferers ought to be cautioned to look for medical focus if they encounter blurred vision or ocular discomfort.
-Hyperthermia - decreased sweating and elevated physique temperature, particularly in hot climate
-Cognitive/psychiatric unwanted side effects which includes cognitive dysfunction,
About My Headaches
That will help you comprehend how Topamax has worked for me, I'll initial share a little about my headaches. I've suffered from tension and migraine headaches for almost 20 years. For probably the most component my headaches weren't debilitating. They had been of fantastic annoyance and most certainly uncomfortable, but I've only missed a couple of days of function due to them. My headaches progressively elevated in frequency and duration and had been at their worst when I was in my late twenties via my mid-thirties when I lastly sought therapy final fall. Before this, I just accepted my frequent headaches, and took Excederin anytime I felt a headache coming on and hoped it would go away--sometimes they did, occasionally they didn’t.
I get each tension headaches and migraine headaches. A tension headache is really a common description for headaches which are generally brought on by environmental elements and/or tension. Mine aren't tension associated, but are brought on by a mixture of elements which includes: poor posture, skipping meals, wearing hats, pulling my hair back, hormonal modifications, along with other medicines. Although I've figured out these causes, and did every thing I could to prevent these possible headache causes, I was nonetheless getting frequent headaches. When I was unable to obtain rid of my tension headaches, they would progress for hours, then days, and I'd then wind up having a migraine headache.
My Encounter with Topamax
Following getting 1 of my much more serious migraines final fall (two along with a half days lengthy and vomiting), I lastly known as and created an appointment at a headache clinic that my mom suggested that was newly covered by my well being insurance coverage. I met having a neurologist, who heads the headache clinic, a dietitian, a physical therapist, along with a psychologist. I also had an MRI on my head to rule out any much more severe trigger. Following ruling out psychological and dietary causes to my headaches, I underwent eight weeks of physical treatment to right some posture problems and muscle tightness in my neck. This has assisted. I was prescribed Relpax to take if I do get a migraine (this medicine functions fantastic for migraines which have currently begun).
On my subsequent go to my physician prescribed Topamax. She stated that the Topamax might even assist decrease my every day tension headaches since the medication functions by desensitizing the brain towards the headache discomfort. I see my physician periodically (ranging from month-to-month to each and every 3-4 months) so she can keep track of my standing. I also need to have blood drawn each and every six months whilst on Topamax to ensure that every thing is in verify. (Topamax can decrease bicarbonate ranges within the blood). My physician also advised me to drink a lot of water whilst taking this medicine to stop kidney stones.
I began off by taking 25mg at bedtime that is regarded as a really reduced dose. Based on my physician, the majority of her sufferers appear to determine the very best outcomes at about 100mg. About an hour following taking it, I observed a tingling sensation in my toes, that is among the most typical unwanted side effects. It felt just about such as the feeling you receive when your foot falls asleep, except that the sensation lasts for only about a minute and it comes and goes in my fingers and toes. The following morning I woke up having a headache that I knew was because of the medication (not like my normal every day headaches). I'm delicate to new medicines, so I assumed that this would pass following a couple of days of taking this new medication. I woke up having a headache for the following 5 days following starting this medication. These headaches went away merely by taking two Excederin tablets. I also observed that I felt sleepier than typical about an hour following taking the Topamax, but this was not an issue simply because I was taking it at bedtime. Following the very first week of taking this medicine, I no longer felt sleepy following taking it, nor did I ever wake up having a headache brought on by it.
My Unwanted side effects
For about two weeks following starting to take Topamax, I skilled a number of other typical unwanted side effects. The majority of these unwanted side effects subsided inside two weeks or so, and if they had not, I most likely wouldn't have already been in a position to carry on using the medication. Among the much more severe and annoying unwanted side effects that I skilled following starting Topamax was difficulty concentrating. I discovered it difficult at occasions to spend focus at function, or to locate the proper word to say. It frequently felt such as the word I needed to say was “on the tip of my tongue”, but I just couldn't get discover it. Additionally towards the minor tingling in my fingers and toes, I started to encounter numbness in my nose, roof of my mouth, and upper lip. I also skilled appetite loss that was very serious initially, creating me need to force myself to consume to get a week. I regained my appetite to nearly regular as I got utilized towards the medicine. Additionally, consequently of taking this medication, I'm unable to taste carbonation. Carbonated soft drinks and beer taste flat to me. I really didn’t discover this immediately simply because I do not drink a lot soda anyway, so this wasn’t a large deal for me. This side impact continues these days. My physician didn't prefer to hear that I had a lot of unwanted side effects consequently of taking Topamax, particularly the cognitive ones, but she stated that they're typical when initial beginning the medication, and it had been fine to carry on taking it because the unwanted side effects had subsided.
I skilled my worst unwanted side effects when just beginning out around the medication. My dose has been progressively elevated to 100mg, and with every dosage improve, I discover a slight dip in my appetite along with a bit of tingling in my fingers and toes. More than the course of eight months, I've lost about 15 pounds although I've extremely small appetite loss any longer. (I guess that's a constructive side impact!) The unwanted side effects differ from patient to patient and may differ based on the dosage also. For instance, my mom requires Topamax also, and has not skilled even a single side impact.
More than the course with the previous eight months, my dosage has been progressively elevated to 100mg each day (50mg at bedtime, and 50mg within the morning). Throughout this time period, my headaches have progressively decreased in frequency and duration. When I initial began taking Topamax, I went for three complete months with out a single migraine! I've not gone that lengthy with out 1 because, but my attacks are a lot milder than they utilized to become. My migraines also respond a lot much better to my migraine medicine, Relpax, that is meant to become utilized following the onset of an attack. Because starting Topamax, my migraines respond to Relpax in 1 dose (by no means two) and my headache is usually gone inside an hour. I only utilized Relpax to get a brief time prior to starting the Topamax, and I did accomplish great outcomes with it, but now I accomplish fantastic outcomes!
I've had a dramatic reduce within the quantity of tension headaches I get also. I utilized to obtain headaches nearly each and every day. I now get headaches about twice monthly. This has been the greatest advantage. These tension headaches are usually what led to the majority of my migraines, and by eliminating the majority of them, I've substantially decreased my migraines also.
Because my physician and I had been unable to locate a definitive trigger(s) for my headaches, we had at first set a realistic objective of decreasing my headache frequency to 1 extremely mild headache per week (It's unrealistic to believe that I'd be 100% headache totally free). As soon as I accomplished this objective, I'd preserve that present dose for about six months, after which start to become weaned off with the Topamax progressively so long as the headaches don't improve in frequency. Issues have already been going fantastic. In October I'll see my physician once more, and at that point she plans on decreasing my dosage. Topamax has been shown to have lasting effects around the brain following about six months of continued use. I'm hoping that I'll no longer require this medication following an excessive amount of longer.
Topamax has been fantastic for me in decreasing my headaches significantly! Following coping with unwanted side effects for the very first couple of weeks, I've been in a position to tolerate this medicine very nicely. I did need to understand to become patient, simply because this medicine requires time to function and appears to function much better and much better more than time. I understand this really is certainly not for everybody, but in the event you are plagued with migraines, or perhaps persistent tension headaches, it may be really worth attempting.
Topamax may be costly in the event you do not have prescription drug coverage based on the dosage that's prescribed. To get a 30 day provide of 50mg tablets (to become taken twice every day) at Walgreens, the price is about $295. Fairly pricey!
Much more info is accessible at Topamax.com