I currently take Verapamil for my preventative, but a new doctor suggested that I try Topamax instead.  Has anyone used both of these before?  I'm looking to see what you think as far as effectiveness of each, dosage restrictions/limitations of each, side effects, etc.

Before my Neurologist got up to speed on Verapamil he put me on Topomax at the same time - then Topomax without Verapamil.

For ME (everyone is different) bringing Verapamil up to 480-600mg was far more effective than the two combined at lower doses. I never tried to ramp up the two together, so I can't offer any insight on that approach. Occasionally, I run up to 720mg when I get into a high cycle, but I average 480-600mg.

I will add that switching away from the "SR" sustained release Verapamil twice per day, to the regular formula several times per day made a huge difference for me.

Just my two cents in a world where pennies are worth nothing............

Marc

Marc wrote on Oct 12^th, 2009 at 8:21pm:

Before my Neurologist got up to speed on Verapamil he put me on Topomax at the same time - then Topomax without Verapamil. My neuro tried both at the same time too. The Topo side effects were untenable. For ME (everyone is different) bringing Verapamil up to 480-600mg was far more effective than the two combined at lower doses. I never tried to ramp up the two together, so I can't offer any insight on that approach. Occasionally, I run up to 720mg when I get into a high cycle, but I average 480-600mg. For me, 960-1040 mg/dy verapamil works best... I will add that switching away from the "SR" sustained release Verapamil twice per day, to the regular formula several times per day made a huge difference for me. SR verapamil did not work, for me...AT ALL. Just my two cents in a world where pennies are worth nothing............ Marc's 2 cents are worth noting...combined we are 4 cents! Best, Jon Marc

Has Verapamil been effective for you? 
Have you been using sustained release or immediated release?
Why are you considering a switch? 

I've never taken Topamax but I'm very leary of anything that has the potential of having cognative side effects.  This is just my personal opinion though.

-Dennis-

DennisM1045 wrote on Oct 12^th, 2009 at 9:09pm:

Has Verapamil been effective for you?  Have you been using sustained release or immediated release? Why are you considering a switch?  I've never taken Topamax but I'm very leary of anything that has the potential of having cognative side effects.  This is just my personal opinion though. -Dennis-

Verapamil has been somewhat effective.  Less and less with the last two cycles though, and I'm leary of dosage increases because of the potential life ending side effects, and I just hate being on it already at a lower dose.  I take both the SR and immediate release.  If the SR doesnt work I switch to the immediate and it works better and allows some playing with the dosage.  The switch is being considered because my new doctor seems to think it will have less side effects and offer greater effectiveness... potentially.  I would like some more real world comparisons.

I was initially put on 100mg of Topamax which I took at night. This was to try and reduce the side effects of the drug.
My new Neurologist put me on Verapamil instead, a low dose 240 mg . He was of the opinion that Topamax was of little benefit for treating CH. We all know here that different things work for different folks.

The side effects of Topamax were beyond what I could handle. Having been said on this thread already the cognitive issues were the most prevelant.
My two cents is that so far I believe I made the right choice in going with the Verapamil instead of the Topamax.

You must be your own guinea pig.

All the best :)

I have been on both at the same time....Topamax can give you the "word search" and make you a little spacy. Especially at 150mg...It can make your hands and feet tingle too and can make you really sluggish in the begining but that usually goes away.

The sick thing is I was only a few months in when I went on the Topamax and after one month (builds up) I went two weeks with out a CH (I have them chronically). I thought I was "cured", I didn't know enough about the condition yet. It stopped working and I got really bad after that break. It finally started to lessen them a little bit but not enough to be worth the side effects. Verapamil never worked for me...I would say try it...I mean really what do you have to lose..Some people have had serious relief from it...Just remember that Topamax takes time to work...Give it a few months b4 you give up on it...

Doesn't sound so hot.  Thanks for the input!

I'm taking both at this time as follows:

Verapamil 480 mg once in the morning (I'm assuming slow release given other posts in this thread)
Topamax 100 mg at night

In week 11 now, was increased to 480 from 360 on the Verapamil about two weeks ago.  I was thinking I might have been on the way out of the cycle as I had not had a bad hit in about a week but had a Kip 6-7 on Monday and a few 4-5 since then.  Laying low wondering where I'm at as we speak...   :(