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390338 tn?1206466248

Elavil/amitriptyline vs. Topamax

I was just prescribed Amitriptyline on Monday for my migraines.  A low dose at 10mg daily before
bed.  Almost 24 hours later I still feel as though I am under the influence.  Not severe,  but enough
to make me feel somewhat sleepy, arms and legs feel a little heavy and a little nervous at the same time.  I am hoping that is is temperary while I adjust to the medication.  Of course I don't know how this will affect or help my
migraines but I can't imagine taking a higher dose and being able to function normally.  I was wondering if anyone has had this experience.
Also,  something I plan on asking the doctor on my next visit in 2 weeks.  I'm wondering why amitriptyline whould be prescribed rather than Topamax?
21 Responses
Avatar universal
Hi Jen,

I'm not a doctor but I do know a bit about Elavil.  I would cut down your dose to 5mg for a week (of course ask the doc) and then 7.5 a week (pill cutter) then up to 10mg if you need that high.  Topamax is an antiseizure med, Elavil is an antidepressant - my own personal opinion is that Topamax has a really great marketing plan and Elavil is an older tricyclic that is gaining claim again becuase of its ability to modulate all pain, help with stress/depression.  But Topamax is very big and does help a lot of people.  Topamax (I took the max dose) did nothing for me personally.

Its really trial and error as which one would help but I have tell you a swear by Elavil (but it makes 25% of its users gain weight).  You'll know fairly fast because you will crave sweets.  Topamax actually makes a lot of user loose weight.

Are these PMS headaches ever?
Ever stressed?

All sorts of questions as to why the doctor tried this one first.  For you personally, I can't say which one is best for you personally but neurologists are usually very good at letting you have input into the choices.  Topamax is more expensive -depending on your insurance etc...  Elevil probably will stable out but you know whats best for you.  Sorry I kind of rambled on this answer - do you have a personal preference of the two???
390338 tn?1206466248
Yes,  for many years my migraines were related to my menstral  cycle.  My first migraine was when I was 12.  I got them monthly like clockwork.  My mother would practically catch me in the door way as I had walked a few blocks from the bus after school. I'm not sure as a young girl how I survived those.  When I was in my mid 20's after the birth of 2 children they increased to more than one a month. My periods started to increase too. Lasting for up to 10 or 12 days.  So heavy that I couldn't go anywhere for a couple of days because I couldn't keep up with it.  After becoming anemic and my migraines so intense and frequent I finally had a thermal ablation.  It saved my life.  It also helped with the migrains a little.  But they are creeping back with very severe migraines again. Before going to the doctor again this week I had, had a 2 week bout with a very severe migraine.  I had some moments where I would feel good enough to get some work done,  but I wasn't really feeling good.  If you have migraines you know what I mean.  I have always tried to push through them as best I could.  If I lay down,  I'm down.  So I would work until I couldn't.
Anyway,  talk about rambling.
I have a list of concerns to speak with the doctor about.  I don't really have a preference.  I think it just concerns me going on a daily med.  I have always wanted to be as med free as possible.  But if I am to live life to the fullest with my family, I can't do it with migraines.
Avatar universal
I am also taking Amitriptyline after trying Topamax. It will make you a little sleepy for a while, but will get better in time. The Topamax caused SEVERE memory loss for me, although it was temporary. It also did nothing to help the headaches. I simply could not function on the Topamax. The Amitriptyline seems to be doing a better job for me.I still have a wierd chemical taste in my mouth that no one can explain. I have had it for about 2 months now.
390338 tn?1206466248
Thanks for the comment.  I am glad to hear that it is working for you.
It gives me some hope.  I have never been very proactive in taking care of my migraines,  even though I have had them for 30 years.  I have always thought it would be better to suffer through them than take a drug.  But my family gave me the kick I need and told me to get with the program,  it's 2008!  I am going to give it some time and hope the side affect fades. The migraines were so severe,  I think the nerves never had a chance to settle before the next one.
I had tried Imitrex tablets a few years ago but they made me so sick and didn't help the migrain.  I am going to try nasal imitrex if I do feel a migraine coming on.  But I have been pretty good this week aside from feeling a little loopy.  It's better than a migrain!
Avatar universal
I have been taking Topamx for over 4 year steady now mostly for migraines, but also for trigeminal neuralgia. I went off Topamax for 3 moths after MVD surgery for the neuralgia, but had to go bavk on the topomax when the migaines went out of whack and a as needed medication called Maxalt wasn;t working, and i'l land in hospital on an IV treatment.  So, for the past four months I have up my dose to 300mg a day from 200 because my neuralgia is back.
As for Amitriptyline I was given it for a sleep aid because i have tinnitus and can't sleep at night. When I found out this was also an anti depressant, I dropprd it because I thought my doctor was tricking me into tacking it, so I take a drifferent sleeping pil. However I am now back tryin ami
itryptyline because it can be useful in helping with tinnitus.

I found your link here while searchin the affects combining these two drugs. my experience with topomax, especially 3 times a day is tons of weight loss. I lossed an incredibal amount of weight in the beginning as i was traning for my black belt degree, and was very active at the time, 20 months ago.
\i am looking for information on what amitryptiline does when combided with topamax. I am on an   Ami dose of 25mg building to 75mg and poss as high as 150mg
Any comments

390338 tn?1206466248
I have already been taken off the amitryptiline because I was still getting so many migraines.  I will say it did help me sleep very well,  even though I didn't consider myself to have any sleep issues except a very light sleeper.  But it did nothing for the migraines.
I have only began the Topamax this week and have started with a low dose.  So,  I have not combined the 2 medications. Good luck.
Avatar universal
Have you had much drowsy with the Topamax?  If you have would you say similar to amitryptline, or much less.  
390338 tn?1206466248
I am not sleeping nearly as hard, and not as drowsy during the day.
But I had a MEGA migraine yesterday and still trying to get over it today.
But of course I only began the Topamax last monday and a very low lose so I guess I can't expect results yet I suppose.  
Avatar universal
enyone here, Know a good doctor in Riveride county ca. Iv  been having migrains vesion hear loss . some time for 1-3 hour and other time just for less then hour. never know how long.
Avatar universal
How are your migraines?  Have you seen any improvement taking Topamax; and have you had any side effects?  Thanks.    Kittycatpurr now Jan 2008
390338 tn?1206466248
My migraines had not seen an improvement up to last week.  I was getting one about once a week lasting 3-4 days.  Very debilitating.  I have had them all my life but not this frequently,
so I wasn't having anytime to recover between.  I have had appointments every 2 weeks with the Dr. to watch how I was reacting to the Topamax while I was increasing the dose.
as of last week I was still only up to 75mg.  I had an appointment on Tuesday and I was
really sick.  I'm not sure how I got myself there but I was determined to make sure he saw me at my worst.  I really like him and think he is working with me but he is not the neurologist and I think maybe he thought it might just be your run of the mill "migraine".
Accept at least this time in my life a Dr. didn't tell me to just take more advil or get more sleep or try deep breathing.  I won't blame my mother for not getting me help in the 70's or even 80's.  I think even today there must be way to many under diagnosed migraines.
Anyway,  the doctor gave me a shot of Ketorolac Tromethemine (sp) an anti inflammatory and pain killer.  It did nothing.  After sitting in the office for a long time
and somehow finally getting myself home. I waited another day before that one finally faded away.  But.....That was last Wednesday and this is Tuesday!  Shhhhhhhhhh.
don't say it to loud!!  And now I have bumped it up to 100mg.  Also,  in the mean time I had a CT scan and have and appt. with a neurologist  on the 29th.  The ct has already come back fine,  oh also he did a complete blood work up.
As far as side affects,  I have now had since I have been bumped up to even 50mg tingling in my fingers and toes,  even a little in my heels.  Some on the left side of my face,  nose and tongue.  A little on my inner thigh,  but that had gone away along with the facial tingling,  unless something else comes with the bump up to 100mg.  The tingling in my fingers and toes is just off and on during the day.  It doesn't bother me to much and maybe will go away with time.  As far a memory loss it hasn't affected me at all.  And it doesn't make me drowsy or wierd feeling either.  I have not lost any weight.  But,  I will stay on 100mg until I see the neurologist. I don't know if he would have me increase or not.  I would have hopes that this dose would work for me.  I don't  know if I told you that I tried Imetrex nasal in combination with Tomamax and they just didn't work for me.  I used 5 in a 2 week period with really no success. Anyway I won't give up on it yet,  I know I have to give it time,  it is hard to be patient.  But I have waited this many years for help,  I guess I can hang on a little longer.  
I could have made this alot shorter and just said the migraines are much worse than the side affects!!  I promise!  
Avatar universal
Just like you i have been a migraine sufferer for many years and topomax did not work for me yet a am at a 200 mg. steady and just added Neurontin 100 mg and are currently at 200 mg. and will increase to 400 mg. so far daily migraines continue with 3 and 4 day clusters just like your self. And i am already getting tired of all this meds. Nothing seams to work. But will keep hope!!! And im glad to know im not alone or going crazy.
Avatar universal
hi i have suffered now with migraines for years and only for the last 4 have they been very bad....had a cycle of cluster migraines and have tried every prescribed tablet my doctor can give me
Due to have my second mri scan tommorrow GREAT!!!!
under the specialist and i to am taking topamax, have experience all the same side effects as yourself and 2 months on they do gradually fade just a slight tingling in your toes and fingers now and then...
i am now done to 2 migraines a month which are around my monthly cycle which is not bad but not great....and recently suffering depression at the loss of my mum passing suddenly and wondered if anyone knew of any side effects with topamax and antidepressents
Avatar universal
i was put on Amitriptyline and i cant function on it, i sleep all day and has caused weight gain (i work out religiously and eat pretty healthy) i feel like im going to fall asleep all day long and just feel not like myself.  i've seriously been considering switchin to topamax but i heard it cause cause major birth defects.
Avatar universal
I have just been put on amitryptiline in the last week by a headache specialist.  I was on topamax for the last three months with more migraines than ever and horrible memory loss, fatigue, trouble getting the words out.  It just depends on your body chemistry he told me.  I have status migraines lasting up to two weeks with no break.  Since starting the amitryptiline I had one only and it lasted two days!!!  Don't want to get too excited but fingers crossed.  My husband already commented on how much better I've been (he haaated the topamax especially since I was still getting headaches).  Believe it or not since my migraines come on very slowly he told me to take two aleve if I feel the least bit of a headache even a scale of 1 and it has a 5% less chance than imitrex of warding off a migraine.  Don't know if it's the aleve or the amitriptyline but somethings helping me!
1024307 tn?1292002086
Hello,how are feeling after 3 mos of taking Elavil? I was on Nortriptyline for 2 weeks. Have not had a single migrene but I was very agitated all the time and had trouble sleeping. Today my doctor put me on Elavil-the same family but hopefully with less side effects. My doctor is really pushing Topamax but after reading some comments about it I'm somewhat scared. If this family of tricyclic antidepressants are working for me why change? I'm not, however, looking forward to gain weight. I have a fatty liver and that's last thing I need is to gain weight. I've been reading about drowsiness taking Nortriptyline but i experienced just opposite. I was wired,hyper and unable to sleep. I'm worried I will feel the same with Amitriptyline (Elavil). Has anyone had these side effects?
1302779 tn?1287408629
Hello April63
I too was put on elavil to try to combat dep/anxiety and migraines and had the same experience as u! It made me VERY HYPER i was on only 5 mg for 2 nights and stopped! I read alot about thee side effect making people sleepy but was the opposite for me!!! We are all different and what works for one doesnt work for another! Good luck
1024307 tn?1292002086
Hello Anthony,thank you for your reply. I had a sleepless night.:(
I'm jumpy and nervous. I'm on 10mg Elavil. Just called my doctor. She prescribed Clonazepam 0.5mg,to help me go through 2 week trial period. I'm exhausted but i will give it a try for 2 weeks,not longer. I suffer from terrible migraines and will go through this trial to enjoy a break.I will let you know if the side effects continue and what the doctor will decide after the 2 weeks, What are you taking right now,Anthony? Does it work? Thank you again-April.
Avatar universal
You CANNOT take elavil and topamax together.  Very bad interaction.  Causes hyperthermia.  Google it....Thanks.
Avatar universal
Can it taking topamax and Amiptriptyline throw you liver enzymes way up like in the 400 and 500 range.
Avatar universal
i have serious daily nerve pain in my legs i have took amitriptyline for a year and a have it seem to work helping 50 percent of my night time pain.but i have gained 30 pounds while on it i am going to ask my dr to prescibe topamax because i hear it helps nerve pain in legs and promotes weight loss.has anyone hear used it for leg pain?
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