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Question
Posted by: Zoey | 2010/02/04

Stopping topomax

Hi Doc.
I suffer from migraines and have been on topomax for 4-5 years now (too be honest I don' t know if it helps, but thats beside the point) We trying to conceive and I know that I need to start ' weening'  myself off the topomax. I started 2 weeks ago by taking every second evening and this week by skipping 2 nights. After that I' ll half my tablets. Is this ok? I' m currently on 50mg. Also, when pregnant, what recommended medication is there for migraines and when having an attack (i have the bad ones, nausea the works), I use Maxalt and 2 Myprodol, which I can' t when pregnant.

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Our expert says:
Expert ImageHeadache expert

Dear Zoey,

It is fine to tail off the Topamax as you are doing.

Unfortunately the only pain medication allowed during pregnancy is Panado – but there is a better way than to rely on medication. The best way to treat migraine is to find out where the pain is coming from, and then treat the cause – in most migraine sufferers, the newest advances in treatment enable us to eliminate the problem permanently. To get to the root of the problem, you need what is called a “multidisciplinary assessment”, which should include a neurological examination to rule out any serious underlying condition. There are so many different structures in the head and neck, all of which can be involved in the headache process, that no single specialist can have all the knowledge necessary to make a comprehensive assessment and diagnosis. For instance, a neurologist will examine the brain and nervous system, a physiotherapist will look at the muscles, a dentist will examine the teeth etc. For this reason, the “multidisciplinary assessment” combines and integrates the expertise of different specialists who would normally treat headache patients in isolation, into a single more comprehensive body of knowledge. This enables the different members of the team to provide a co-ordinated treatment plan, so that all the contributing factors are addressed.

This assessment must include a thorough examination of the head and neck muscles to determine the presence of abnormal tension, and of the external carotid vasculature to determine whether there is an arterial element to the pain.

Headache sufferers often have a poor Quality of Life due to the constant pain and associated symptoms. For a free assessment of how your headaches are affecting your Quality of Life, click on http://www.headacheclinic.co.za/

This information has been supplied and checked by the multidisciplinary team of specialists at The Headache Clinic, in association with The International Headache Society and the South African Institute of Headache and Migraine Science. For consultation with these specialists, call The Headache Clinic (Cape Town, Durban, Johannesburg) on 0861 678 911.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

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Our users say:
Posted by: Headache expert | 2010/02/04

Dear Zoey,

It is fine to tail off the Topamax as you are doing.

Unfortunately the only pain medication allowed during pregnancy is Panado – but there is a better way than to rely on medication. The best way to treat migraine is to find out where the pain is coming from, and then treat the cause – in most migraine sufferers, the newest advances in treatment enable us to eliminate the problem permanently. To get to the root of the problem, you need what is called a “multidisciplinary assessment”, which should include a neurological examination to rule out any serious underlying condition. There are so many different structures in the head and neck, all of which can be involved in the headache process, that no single specialist can have all the knowledge necessary to make a comprehensive assessment and diagnosis. For instance, a neurologist will examine the brain and nervous system, a physiotherapist will look at the muscles, a dentist will examine the teeth etc. For this reason, the “multidisciplinary assessment” combines and integrates the expertise of different specialists who would normally treat headache patients in isolation, into a single more comprehensive body of knowledge. This enables the different members of the team to provide a co-ordinated treatment plan, so that all the contributing factors are addressed.

This assessment must include a thorough examination of the head and neck muscles to determine the presence of abnormal tension, and of the external carotid vasculature to determine whether there is an arterial element to the pain.

Headache sufferers often have a poor Quality of Life due to the constant pain and associated symptoms. For a free assessment of how your headaches are affecting your Quality of Life, click on http://www.headacheclinic.co.za/

This information has been supplied and checked by the multidisciplinary team of specialists at The Headache Clinic, in association with The International Headache Society and the South African Institute of Headache and Migraine Science. For consultation with these specialists, call The Headache Clinic (Cape Town, Durban, Johannesburg) on 0861 678 911.

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