I'm two-thirds of the way done titrating my much-needed Topamax, and as always when I'm at my wit's end, I've decided to diary about it so that there's something in the queue. :)
I finally have insurance, and the medication that was over $700 a month without insurance is suddenly $10 a month. I picked it up as soon as I was able to, and started the long, drawn-out process of 'titration'--slowing increasing the dose of a medication until it reaches effectiveness, hopefully without having side-effects that are too severe.
Starting Topamax at 400mg a day, the dose that was effective for me before, would knock me ass over heels, and would be incredibly dangerous. Oh no, the most you can start at, per day, is 50mg. And you can raise it by 50mg each week. You really feel it each week, too. I'm still getting migraines, and I'm at 300mg (my migraines are primarily caused by hormones, but also by stress, and I tend to synch in with whatever females I'm living with really, really quickly, so I've had 3 cycles in 1.5 months. Heavenly, eh?).
So, the side effects I tend to get from Topamax are verbal aphasia (can't think of words), extreme sleepiness, clumsiness, extreme loss of appetite (although I will eat if it's put in front of me, I don't get the loss of taste some experience), ennui, and a huge sense of just being disconnected.
Yes, I make sure to eat one meal a day. Frankly, I really, really hope the other, usual side effect of Topamax kicks in...weight loss. Right now I'm almost 200lbs, even though I usually walk about 8-10 miles a week and struggle to eat 1200 calories a day without meds messing with my appetite (hypothyroid disorder, remember).
But right now I can't even focus as much as usual. I got maybe 5 stitches into an embroidery project that's really important to me, and had to put it down. I couldn't tell where the next stitch should go, and I've been doing embroidery since I was a kid.
I sleep or doze most of the day away, watch a few episodes of feel-good sci-fi on Netflix and crochet (mindless for me), then go to bed after taking my meds. I never feel like I've really woken up. I'm stiff and sore, but that just could be because I'm not moving as much as usual since I've starting hitting the higher doses (once I get used to them, I will be, I have done this before).
Sometimes I get brief spells of wondering why I'm even here, but those I snap out of pretty quickly. That's when I go get a cup of tea. Tea fixes everything.
One day I saw flashing striations of purple light, which worried me for a second, but then the migraine hit like a tidal wave, and I realized it was an actual breakthrough migraine, which meant that it was starting to work.
Note: Topamax in no way helps a migraine in progress. What it does is decrease abnormal excitement in the brain, preventing a migraine (or seizure) from occurring. However, it's not always foolproof--and when a migraine 'breaks through' it tends to be really, really bad. It had to be, to get through the barrier the Topamax was putting up. Think of it as a sea wall. Yes, it holds off the most of the surf, but what does come through during a bad storm is pretty damn devastating, eh?
Now, for me, the Topamax is actually for more than just the migraines. I have a history of seizure disorder, from a TBI at age 2. I have a new TBI from 2010 causing different issues. I have PTSD, and Topamax is often used to help with mood disorders (they're trying to get bipolar on label). My psych was more than happy to switch Seroquel for Topamax when my PCP requested it, since it would do many of the same things with more functionality (and fewer side effects). It will also help with my fibromyalgia, since research has shown that seizure medications in general tend to help with fibro.
All of this may explain why my effective dose is almost 200mg higher than most people who take it for 'migraine suppression'. Or it could be the circumstances of my birth. I've always tended to be either hyper- or hypo-sensitive to medication. I'd OD on a 'normal' dose of Dilantin, and my seizure disorder was fully controlled on a pediatric dose, lol.
Anyway. I'm frustrated because I can't concentrate worth a damn, this has taken several hours to write, and I have 2 more weeks to go before I'm at my full dose (which is also the maximum dose). I'm grateful that I'm able to have it, but damn does the process suck elephant ass!