Well, you do not want to take pain pills too often because you can get rebound headaches, but by the same token, you do not want to be miserable with headache either.
I'm sorry this reply is so late- I have not been on here in such a long time!
I would recommend finding another neurologist, one who uses a combination of a preventative and abortive medications. I also recommend, if you are able, using the heavier duty pain medication such as your Vicodin prescription only as an emergency medication when non-narcotic pain relieving efforts fail to work.
I personally use extra-strength tylenols or ibuprofen for my migraines in combination with phenergan generic, 25 mg at night. I try to hold off on the promethazine until at least after six p.m. for the best opportunity of a successful treatment, using ice paks on my head if needed to try to freeze out the pain.
This treatment would not have been effective for me prior to a lot of acupuncture and my body getting off of narcotic pain relieving meds which my body had grown dependent on.
I now have demerol generic pills for my emergency medication and don't tend to use it more than maybe a couple times a year. I also don't take a preventative anymore and have had a hysterectomy, which has helped in, though not eliminated my migraine problem
I have to agree, sounds like your old doctors was screwing you up, topamax is a last resort drug for chronic migraines, not someone who gets them occasionally. if you only get them occasionally then you dont need to mess around with preventive medications if you dont have to. Especially topamax. I have chronic migraines and i've had to go on the topamax, but i HATE it. the side effects suck. but nothing else works. also, like the person before me said pain meds can cause rebound headaches, not to mention you can quickly build a tolerance. Their are specialize abortive medications for when you get a migraine that you should talk to your doctor about. Like imitrex.