Saturday, November 08, 2008

Migraines Versus Topamax

By Diana Hsieh

Hooray! I seem to be past my recent two-and-half week spell of daily migraines. (Yes, that means I had a migraine every day for about 17 days.) From the outset, I knew the cause of my troubles: I'd recently stopped taking the birth control pill after about 15 years of nearly consistent use, so my hormones were totally out of whack. (No, Paul and I are not having children; we've just changed birth control methods.)

I'd hoped that the situation would resolve itself, but no such luck. By the second week, the migraines were becoming harder to control with my drug of choice, Excedrin. Even Maxalt, my stronger prescription triptan derivative, wasn't always effective. Frustratingly, even when I wasn't in pain, I was often suffering from a kind of "migraine hangover" that left me unable to think clearly. It was debilitating. And, by gosh by golly, I have a dissertation to write.

Normally, to break this kind of migraine run, I go on beta-blockers for a few weeks. They work, albeit with some unpleasant side effects. By lowering my heart rate and blood pressure, any kind of physical exertion -- including the simple act of climbing a set of stairs -- becomes an exhausting chore. However, since the beta-blockers in my medicine cabinet expired in 2005 (that's an indication of just how long it has been since my last run of migraines) I made an appointment to see my doctor for this past Thursday.

And wowee, I'm glad that I did. My doctor offered me a different medication to prevent migraines: Topamax. Now, three days later, my migraines are gone. I felt fantastic all day today -- nary a hint of a migraine, nor even any of the common side effects of the medication. Today I even lifted weights without any fatigue. (My good results may not be representative, of course; in general, my migraines are pretty responsive to medication.)

Interestingly, Topamax used to be used to prevent seizures, but it's now more commonly used to prevent migraines. And:

It is not entirely clear how this medication works for epilepsy or migraines. An epileptic seizure occurs as the result of abnormal electrical signals in the brain. Topamax slows down those signals, helping to prevent seizures. The medication also works similarly for migraine headaches. It is thought that migraines may be triggered by nerve cells in the brain that are too easily excited. Topamax helps calm the nerve cells, working to prevent a migraine from ever starting
Notably, migraines used to be thought of as a vascular disorder, but that's been proven false in recent years. More recent research shows that their origins are "neurological, related to a wave of nerve cell activity that sweeps across the brain."

I will have to wean myself off the Topamax carefully in a month or so. If I stop cold turkey rather than follow my doctor's instructions about tapering off, I might cause a seizure. That wouldn't be good, obviously. Of course, I'll have to see whether I develop any of the various common side effects of this new drug. However, for the moment, I'm absolutely thrilled with it in comparison to beta-blockers. I feel like I have my life back, at the cost of a few measly bucks.

So... THANK YOU, BIG PHARMA!

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