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Question
Posted by: heidi | 2012/09/11

re: topamax

thanks doc for your advice. yes, he should have but you know most gp''s don''t actually explain any side effects ever. i am also having my thyroid tested (can possibly contribute to the frequency and severity of attacks). i have been in contact with dr shevel (headache clinic) and he thinks i will be good candidate for his surgery. i have to go for the assessment first though and need to find out if my medical aid will cover the operation. my gp has prescribed trepilene (which did not help at all) and i am currently on maxalt, which is very costly at R200 odd rand for 3 wafers. my gp has also suggested botox injections but i am very reluctant to go for that but also at my wits end. i have read mixed reports on topamax but think i might give it a try and hopefully it will help. thanks so much.

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Our expert says:
Expert ImageCyberShrink

I notice that GPs these days seem intensely interested in doing thyroid tests ( I've never come across these as useful in migraine conditions ) and brain scans. I would be highly cautious about any suggestion of Surgery for migraine, as this is also not accepted as a standard remedy. I'm also not yet convinced that Botox injections are useful ( or I'd have tried them myself !).
What troubles me is that more routinely accepted meds don't seem to have been tried. Yes, some people do respond usefully to the old antidepressant Trepiline, and some don't. Maxalt is a very new and expensive drug at least primarily intended for migraine, but there are others, a bit older and less expensive usually, related to maxalt, such as sumatriptan, and at least 5 others. Even very old meds like Cafergot help some people, usually those with very long-lasting geadaches.
I think CBT style counselling can help one to control better one's anxiety and other reactions to the onset of a migraine attack, and to relax when this would be useful.

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Our users say:
Posted by: cybershrink | 2012/09/11

I notice that GPs these days seem intensely interested in doing thyroid tests ( I've never come across these as useful in migraine conditions ) and brain scans. I would be highly cautious about any suggestion of Surgery for migraine, as this is also not accepted as a standard remedy. I'm also not yet convinced that Botox injections are useful ( or I'd have tried them myself !).
What troubles me is that more routinely accepted meds don't seem to have been tried. Yes, some people do respond usefully to the old antidepressant Trepiline, and some don't. Maxalt is a very new and expensive drug at least primarily intended for migraine, but there are others, a bit older and less expensive usually, related to maxalt, such as sumatriptan, and at least 5 others. Even very old meds like Cafergot help some people, usually those with very long-lasting geadaches.
I think CBT style counselling can help one to control better one's anxiety and other reactions to the onset of a migraine attack, and to relax when this would be useful.

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