Topamax as an Alternative to Lyrica

[dustybrown]

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!

[DnnTrry]

Thank You so much for the info!! I want go back to my pain doctor till Feb. I have been coming off of the Lyrica. I thought i would do this first. Then when i go back to the doctor in Feb, I will question him about it. The Lyrica has really put alot of weight on me. I do feel bad about myself. I have gotten to where i do not care about myself, how i look or dress anymore, cause i do not even want to get out of the house. I have never been this big before, not even when i was pregnant with my daughter. I am about 5'4" tall and weight is about 176, so now you can see why! The Lyrica has put about 35 pounds on me. I would love to try the Topamax. He had me taking two 25mg at bedtime. I did take one 25mg one night cause my head was hurting bad. Is Topamax best to take durning the day or night? I think i will try 25mg once aday for a week then go up to 50mg the next week, then stay on 50mg for awhile to see what that will do. I hope this will help me.  Thank You again for the info. I can use it.

[FurballsMom]

This is the first I'm hearing of Fioronal.  It's for migraines?  I'm having a hard time focusing--does this one have an NSAID in it?  I believe my neurologist is planning on prescribing a beta blocker for the migraines themselves.  I hope it helps.  He hasn't said anything about Topamax.  I sort of wish we could try that, since I need the help with the FMS, too.  But, he did say that migraines are a life long illness one is born with, so we may get to that later.

[dustybrown]

Unfortunately, Fibromyalgia often requires a "cocktail" of medications to control symptoms, so you may be able to cut back on some of your medications, but there is a possibility that you will still have a need to hang on to some of them too. Since Fioronal is for migraines and Gabapentin is very similar to Topamax there is a strong chance that you would be able to get rid of those medications if your body responds well to the Topamax. I take Soma as well as Topamax, so my guess is you may still need that one at least occasionally. Again, it's really hard to tell how your body will react. You would have to discuss this with your doctor and go through a trial run and see if it works for you. Good luck.  

[Piper222]

I was overdosed on this medication given 400mg instead of 25 with severe consequences.  Tried it again a couple of times but nervous about side effects.  What strength do you use.

[Piper222]

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.

[dustybrown]

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