The Vestibular Migraine Community
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For those on topamax for MAV please help about the dose!


Did you have the weird constant imbalance /disequilibrium /light headedness symptoms?.. If so which of these do you feel helped with that?


It helped with all of them and more because, as my neurologist said, I had every single symptom VM can throw at us.


Here is Dr. Hain’s flow chart:


all day 24/7 on top of that I also had and I’m still experiencing head motion intolerance n light headedness in general. seems to get worse with stress and fatigue and before that time of the month. I’ve noticed I always feel better I get some sleep esp in the morning. did u have that too?


I haven’t tried effexor, nortryotylline or verapamil though. just kinda went straight to topamax. think it would be worth it to try out the others first as they have been mentioned first? ( although not sure is it because of efficacy or less side effects)


I cannot advise on effexor as I never tried it. I was put on verapamil ten years ago for a heart arrhythmia which did nothing for VM symptoms so I can only say that the best combination for VM for me is topiramate and nortriptyline. I know some people struggle with topiramate, but some people struggle with a lot of meds so as you have topiramate already I would go slowly with a very small dose and ask to add on nortriptyline in a tiny dose too. If it doesn’t work then you can try another combination . I think it is all too easy to take too much too soon and then dismiss the med as a problem. I do hope you find the right combination soon and get your life back.


thnk u for the advice dear, I know topamax is a medication that is slow to work and I have only been on the 75mg dose for 8 days now so it’s too early to tell. I guess I’m just anxious about it being the correct med for me esp that its theb3rd option on Dr Hain’s list but I was advised to take it a few years back for migraine control and it worked well on the 100mg do we so I’m hoping it does the same again once I work up to the same dose again :slight_smile: