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Topamax as an Alternative to Lyrica
I have been prescribed Lyrica and couldn't deal with the weight gain, bloat, and tiredness/laziness that it caused in me. Topamax which is used for severe Epilepsy and Migraines works just as well for Fibromyalgia and Neuropathic pain as Lyrica I have found.
There are a couple of key things to note with the drug however:
First, you must be titrated slowly (no more than 25mg per week increases) because of side effects like nervousness and insomnia, hand and foot tingling and loss of appetite. These side effects do go away after about 6 weeks. By increasing slowly your body has a chance to adjust.
Many inexperienced doctors make the mistake of increasing people WAY too fast. (I think they believe Topamax is tolerated just like Gabapentin or Lyrica.) Because of this their patient's side effects become unbearable to the point where the person gets confused, panicky, anxious and just plain fed up with it all and quit the medication before the benefits are made clear. This doesn't happen when the medication is increased slowly.
Second, you need to be at 150mgs or more to get pain relief benefits. You may start to notice relief of your migraines at as little as 75mgs, but to get the full benefits of the pain relief and of any neuropathic pain, you have to be at a higher dosage.
One thing to note is that most people will lose weight on Topamax. Those who have good eating habits when they start Topamax, will lose the most. Those who have the worst eating habits will lose the least. The average percentage I think it 3.5% of your body weight. I have lost about 20lbs, which is 15%. I was an avid Weight Watchers member before Topamax. I know many people who weren't and only lost a few pounds. It just depends on your habits. The one thing is for certain though, this med is not like Lyrica- it's not likely to make you gain weight!
There are a couple of key things to note with the drug however:
First, you must be titrated slowly (no more than 25mg per week increases) because of side effects like nervousness and insomnia, hand and foot tingling and loss of appetite. These side effects do go away after about 6 weeks. By increasing slowly your body has a chance to adjust.
Many inexperienced doctors make the mistake of increasing people WAY too fast. (I think they believe Topamax is tolerated just like Gabapentin or Lyrica.) Because of this their patient's side effects become unbearable to the point where the person gets confused, panicky, anxious and just plain fed up with it all and quit the medication before the benefits are made clear. This doesn't happen when the medication is increased slowly.
Second, you need to be at 150mgs or more to get pain relief benefits. You may start to notice relief of your migraines at as little as 75mgs, but to get the full benefits of the pain relief and of any neuropathic pain, you have to be at a higher dosage.
One thing to note is that most people will lose weight on Topamax. Those who have good eating habits when they start Topamax, will lose the most. Those who have the worst eating habits will lose the least. The average percentage I think it 3.5% of your body weight. I have lost about 20lbs, which is 15%. I was an avid Weight Watchers member before Topamax. I know many people who weren't and only lost a few pounds. It just depends on your habits. The one thing is for certain though, this med is not like Lyrica- it's not likely to make you gain weight!
Regarding the Firoinal and the Neurontin:
The Fiorinal is the medication that should be taken as needed at the onset of a migraine...
The Neurontin is a medication that can take a while before you start to feel the full benefit of the medication. Additionally, this is one of those medications that should not be stopped abruptly without talking to your doctor first because it it has to do with the nervous system (nerves and brain). If you don't take this medicine daily/twice daily/three times daily like it is prescribed, and only take it "when you feel like its needed" then it actually won't feel like its working because the levels in your system will not be at effective levels. It is much like a blood pressure medicine... you take it to keep the problem away, even when it seems like it is no longer there because if you stop the med it will come right back.
About the Topamax replacing both, I would doubt that it would replace both medications because it is a preventative medication. It does not treat those migraines that happen (break through migraines) even when on prevention meds. I use it for my migraines and I still require my second prescription for my acute migraines when they do break through the prevention medication (even though it is less often). It has helped so much with my FM! This was a very unexpected but welcomed surprise! I was not on any meds for it but it totally gave me my life back!
The Fiorinal is the medication that should be taken as needed at the onset of a migraine...
The Neurontin is a medication that can take a while before you start to feel the full benefit of the medication. Additionally, this is one of those medications that should not be stopped abruptly without talking to your doctor first because it it has to do with the nervous system (nerves and brain). If you don't take this medicine daily/twice daily/three times daily like it is prescribed, and only take it "when you feel like its needed" then it actually won't feel like its working because the levels in your system will not be at effective levels. It is much like a blood pressure medicine... you take it to keep the problem away, even when it seems like it is no longer there because if you stop the med it will come right back.
About the Topamax replacing both, I would doubt that it would replace both medications because it is a preventative medication. It does not treat those migraines that happen (break through migraines) even when on prevention meds. I use it for my migraines and I still require my second prescription for my acute migraines when they do break through the prevention medication (even though it is less often). It has helped so much with my FM! This was a very unexpected but welcomed surprise! I was not on any meds for it but it totally gave me my life back!
I have been on Lyrica for exactly one year and have gained 40 lbs!! I told my doc this morn that I had taken myself off of it. He has now switched me to a trial of Savella.He said that most people only gain 5 lbs. But I told him he has known me personally for 15 yrs and that he has to remember that 9 yrs ago I had a gastric bypass and lost 175 lbs and have kept it off and even lost too much at times and was diagnosed with malnurtirion and malabsorbsion. I started gaining right after the Lyrica started even though the first 2 mos on it were the most active time in my life in the last 5 yrs probably. I was eating 3 balanced meals a day and actually had my first job in 5 yrs taking care of an elderly man and doing his daily care and physical therapy such as walking. Unfortunately he had a stroke and my job ended when he had to be in nursing home but no matter in those 2 mos I gained 15 lbs. In the next 10 mos and 20+ lbs, I took care of my Dad when he was dying of lung cancer and I suffered from extreme dental pain and ended up having all my teeth extracted...all this while gaining so much weight...no way was it anything but the Lyrica.
Topamax I had been on for several years for seizure disorder, migraines. Never noticed many side effects with that. Anyone on Sarvella?
Topamax I had been on for several years for seizure disorder, migraines. Never noticed many side effects with that. Anyone on Sarvella?
I had spinal surgery 6 months ago, sufferered from Anxiety and now depression. Was taken off Ativan and Neurontin in a hurry for Surgery. Pain has been horrible every since. Now trying Cymbalta again and am on Remeron and sleeping pill to sleep. I can not walk on my own, not just dizzy but the floor and walls move. Some of it is from anxiety some from the Topamax.
Hello and welcome,
I am so sorry (and appalled) to hear that you were placed on such a high dose right off the bat. I hate to ask how this type of thing happened to you??? I can totally understand why you would be fearful of trying it again.
I was in pretty bad shape when I started Topamax. I was in severe withdrawal coming off of Neurontin way too fast. Also I suffer from Fibro, plus scoliosis, DDD, degenerative facet arthritis of the spine, nerve damage of the spine, plus a failed shoulder surgery and a whole bunch of other odds and ends. I am in pain daily. Topamax helps a lot with my migraines and slightly with my nerve pain. I started at a low dose (25mg) and SLOWLY ramped up to 175mg. Doing it this way helps to avoid these horrible side effects you went through. I do take an NSAID and a muscle relaxer as well. I hope this helps you. Take care.
-Dusty
I am so sorry (and appalled) to hear that you were placed on such a high dose right off the bat. I hate to ask how this type of thing happened to you??? I can totally understand why you would be fearful of trying it again.
I was in pretty bad shape when I started Topamax. I was in severe withdrawal coming off of Neurontin way too fast. Also I suffer from Fibro, plus scoliosis, DDD, degenerative facet arthritis of the spine, nerve damage of the spine, plus a failed shoulder surgery and a whole bunch of other odds and ends. I am in pain daily. Topamax helps a lot with my migraines and slightly with my nerve pain. I started at a low dose (25mg) and SLOWLY ramped up to 175mg. Doing it this way helps to avoid these horrible side effects you went through. I do take an NSAID and a muscle relaxer as well. I hope this helps you. Take care.
-Dusty
How bad were your fibromyalgia symptoms when you started Topamax and did you really see a big improvement? Wondering if I should try it again, on 400mg given by accident had brutal hallucinations, chest pain, breathing trouble, no concentration.
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