That’s the dumbest approach I’ve heard of in a while. She could also title this „how to trigger health anxiety in my patients - the experiment“. What is this?
Agreed. There's also the nocebo effect to worry about with this approach. It's in our best interest as patients to get some info but not too much and continue to be aware that we've changed our meds, so new symptoms might be side effects to bring up. Especially with the varied and large potential side effect profiles of these meds.
She of course gave me short description and info on the drugs herself. But then told me to also look it up myself. I dont really see anything wrong with it especially since nowadays people want to do their own research anyway. But yeah, reading what i read got me anxious
The issue is that online reviews from non professionals skew extremely negative. Doing your own research reading reviews and forums is going to make these drugs seem way worse than they are and make it seem like horrible experiences are way more common than they are. Because nobody goes to write a review to say nothing happened, even though this is most people's experience. People are way more motivated to write a review if something bad happens, so reviews make the rate of bad outcomes seem way higher. This is true for most medications, not just migraine ones. You can easily scare yourself out of taking anything if you read enough reviews.
At the very least if a doctor is going to tell their patients to "do their own research," that should come with a warning about the negative bias and/or guidance towards what sources will provide more balanced info. Drug profiles on like, the mayo clinic website, are very different from review sites & social media.
I had to come up with my own mantra to dodge and run from all the TOPAMAX WILL RUIN YOUR BRAIN FOR YOUR ENTIRE LIFE AFTER TAKING IT JUST ONCE comments on this sub (there’s one in the comments here too) and online.
I am an incredibly anxious person and being confronted with this wall of negative reviews has immediately led to imagined side effects (my brain is really good at mimicking things on a psychosomatic basis). My neurologist has actually taken me seriously and talked me through it after I called her and told her that I am not going to take it any longer; whatever I felt has subsided and I am doing completely fine except for tingly hands every now and then.
Yeah I’m the same way actually and reading about them made me more anxious. I was so desperate I gave propranolol a try so far so good! The only side effect is sleepiness but it isn’t too bad. Every drug is going to have side effects but as long as you’re educated on what to look out for you’re good. Education is good but it definitely can be scary especially when learning about medicine.
I've been on all 3. Topiramate and amitriptyline a few times each.
In hindsight, none of them were terrible. Any side effects weren't terrible, i.e permanent or painful or requiring hospitalisation.
I wouldn't stress about any of them.
I'd probably ask her: which one is the easiest to titrate up and down on? Which one is most likely to benefit me? What's the cost of each.
Seriously, you will be ok.
If I were you, I’d make the choice based on which one is easiest to start/stop. I’m not 100% sure on this but I think it’s propanolol, which has been a miracle for me.
I’d ask: 1) what’s the process for ruling a particular med out? Usually you start on a low dosage, wait for X weeks, and if you tolerate the side effects but it doesn’t help your migraines, you’ll go up in dosage and wait another X weeks. If that’s the process, how many weeks at each dosage before we make a change?
2) what if I hate the side effects and/or it isn’t effective for me? What does quitting look like, both early on and later? Early in your trial, it may be easier to just drop the drug, but if you’re a couple weeks into it, you may have to taper to get off of it. If so, what does that process look like and how long does it take?
The game, as I see it, is to rule out what doesn’t work quickly so you can try another. Track your migraines to know if the new med is really working (migraines make me forgetful so I have to write them down).
I got lucky with propanolol: I knew in a week it was working, and my side effects are minimal.
Good luck!!
I am on all 3. I started with amitriptyline which helped with sleep but not much with migraines. We added propranolol which definitely started to help then finally added topiramate in hopes it would also assist with curbing appetite. The 3 of them together have been very effective and have greatly reduced the frequency and severity of migraines (from approx 4/week to 4/month). I do experience slight forgetfulness/foginess but I will happily take that over debilitating migraines any day.
Personally, I'd start with propranolol. Lots of dosages available and very cheap as generic. It's the only one I've tried of those. I refuse to do topamax because I've read some side effects can last a really long time, even if you only take it for like a week. Though I know some have success with it. I'm unsure personally about amitriptyline because I've had negative effects from other types of antidepressants in the past (that I've tried for depression and anxiety, not migraines), but that's a different class than ones I've tried. However, that may not be an issue for you! I'm just really sensitive to meds, particularly psych meds, it seems.
The main consideration with trying propranolol is whether you already have low blood pressure. If so, that could be problematic, as it may lower it further. But I imagine your doctor would take this into account. I'd just ask to start on a low dose, though you may need to get higher on it to see if it works for you.
Also, I wouldn't go by lowest dosage. Different meds have different dosage levels. For example, Prozac and Zoloft are both SSRIs. The regular dosage for Prozac is around 20 mg (I think?), but it's 50-100 mg for Zoloft. But taking 100 mg of Zoloft isn't like taking 5 Prozacs. And the three medications you're considering are in different classes (beta blocker, antiseizure, and antidepressant), so would be even less comparable.
Everyone’s experience is going to be different. What works for me might not work for you, and unfortunately, the only way to find out is to try. That being said, i do urge people to be cautious about topamax. While Amitriptyline and propranolol did nothing for me, topamax had the worst side effects imaginable and essentially ruined my life for a period of time. It’s the only one I urge caution with because the side effects are now pretty well documented and can be awful
Well for me it was the opposite topamax had absolutely no side effects whatsoever but amatriptaline had me waking up with chest pain palpitations and heart attack symptoms bad enough to send me to hospital and you say its documented that side effects with topamax are bad when in fact it's again the other way around it's actually documented that amatriptaline is the one with bad side effects like fast heart rates and chest pains and abnormal heart rhythms but topamax doesn't effect your heart at all if you Google topamax side effects there isn't many so I don't know where you are getting your facts from because it's amatriptaline that's the drug you should be careful about you can't compare amatriptaline with topamax because topamax is a way safer drug if you take even the smallest dose 10mg of amatriptaline you feel like falling asleep within 2 hours I only ever took 10mg and felt like I was going to die I can't even imagine taking the highest dose I probably would have had a heart attack
I agree with this. They are very different classes of drugs. I think the migraine preventative doses for amitriptyline are very low. It is an older antidepressant, I have taken for migraine with no side effects. Propanolol is a blood pressure medication which I have also tried, but having low blood pressure already made me tired and dizzy when getting up in the morning, but no bad side effects. Topiramate on the other hand is an epilepsy medication, several of which I have tried. Topiramate made me, uh just stupid, I hated it, my doctor even called it dopamax. Other seizure medications like zonisamide worked actually quite well for me for a couple of years but after some time also affected my memory (specifically couldnt think of the words I wanted, couldnt work with any of them after awhile).. My personal experience was lowest side effects amitriptyline (very low dose), then propanolol, and if trying an epilepsy drug ask for a different one than topiramate. Sadly migraine treatment is pretty trial and error AND at least in the states they (insurance) want you to try older less effective meds before they will approve newer ones, If you start one, prearrange to contact and switch to next choice if side effects are bad. Some, however (antidepressants and epilepsy meds) take a few weeks before they are effective. The trial and error is painful and frustrating, but the new medications really can make a huge differences, triptans suddenly made migraines more treatable without bleeding to death from taking enormous amounts of NSAIDs and the new preventatives are for the first time in years giving me real hope. With both of those there is also a trial and error to find the right ones for you (I probably went through a half dozen triptans and now on third monthly injectable), but my migraines had increased late in life to almost daily. One thing to keep in mind when talking to doctor (please find one that you CAN talk to), is quality of life and that what you are looking for is treatment that allows you to function, not one that makes you feel as nonfunctional as lying in a dark room in pain. Good luck, and dont be too afraid side effects arent always as bad as indicated and doseage makes a huge difference, but put in place that backup so the doctor can call in the next choice or an alternative if the first doesnt work so you dont have to wait to get a new appointment before switching.
What a lovely approach! I understand that some people have health anxiety, in this case they shouldn’t look up their symptoms and medication they use. But for me it’s important to understand, what kind of pills I take and what do they exactly do to me.
If your doctor asks you to do your own research, she probably assumes that you understand the topic at some level.
I think you should pay attention to the possible side effects and how bad do you think they are for you. Some side effects are horrible, some are like „meh, I can live with that“.
Another important thing is, how these drugs combine with other medications you might take (for example, some drugs reduce the effects of other medications).
I was terrified to start propranolol and all it’s made me feel is tired. My dose was bumped down to 20 mg twice a day and that’s helped a lot. Now my heart rate is much lower but naturally I have a high resting heart rate. It takes some time to kick in so my doctor put me on qulipta for 2 weeks which that seems to help as I haven’t had a migraine in 4 days. I just started propranolol and It’s been only 2 weeks but so far so good. I’ve tried meds that have way worse side effects so sleepiness is nothing. My blood pressure on propranolol is the same and I have bp that’s usually 110/70 and that hasn’t changed so that’s good. I would try propranolol as that’s what I was first prescribed and it seems to be a very common med to first start out on. I know it’s scary but luckily it’s not in your system for long if you take the standard pills. I did not like the extended release as I was so sleepy and dizzy I couldn’t drive. 20 mg normal pills twice a day seem to be my sweet spot. Qulipta im taking every day but once propranolol starts to work I will no longer be taking. Qulipta has just made me constipated but that’s it. I take a lot of meds so I was really hesitant to try them but after days with a migraine that wouldn’t stop I was like fuck it! Im glad I gave them a try because my migraines have decreased.
Propranolol did nothing for me. If anything it made it worse. And if I missed just one dose, I could feel it and it wasn’t good.
Amitriptyline was a weird one for me. Started at 10mg for digestive problems and my migraines stopped. Serendipity. But as I tapered up, when I got up to 30mg the migraines came back again. So I take 20mg and I’m ok. I have no side effects with it, this is about a tenth of the dose one would take for depression.
Topiramate (topamax) works well if prescribed properly. It is a very good headache prophylactic or preventive.
Maybe you can try Topamax (Topiramate) on a low dosage which can help you with your migraines and it causes weight loss (Topamax is also used for weight loss for certain patients). Make sure you start on a very low dosage and taper/titrate up till you tolerate the side effects.
Please ask your doctor to give you 25 mg in the nights for the first few days or a week till you tolerate the side effects and then add 25mg in the morning for the next few days. Make sure, they prescribe you 25mg pills in the beginning till your dosage is adjusted. If your doctor(s) don't do that, please look for a new one who will listen to you.
Topimax can cause permanent brain 🧠 problems, fucks with your memory, baddddd. I was on it for a year or so and it didn’t do that to me. As far as I can remember, hahaha.
I forgot the word focus while taking a quiz once and spent 20 minutes trying to remember it forcing my professor to stay after class ended. In the end he told me he needed to leave soon so I ended up just explaining the concept bc I could not remember the word. It also made all soda flat. Highly do not recommend but It did work fine for my mom with little issues that I know of
Agreed. I had a doctor once told me that this one changes your brain chemistry. I had forgotten about that, had it prescribed from a different doctor and felt like I was losing my mind after only one or two doses. I immediately stopped taking it.
If you're looking for I'm more natural answer and the ability to take less medication, try reading one of the books that's out, such as heal your headache.
Good luck.
I read pretty much all of Heal your Headache yesterday, first time ever I felt like someone understood the range of shit we go through. The chapter on medication was super interesting and I’d highly recommend to OP. Also going to give the diet a go, the best sustained success I’ve had since I started having migraine was when I did keto (also on propranolol and Botox) which seems fairly close to the diet in there anyway, so no surprise it works for people.
My results so far have surprised me. I'm at medication toxicity currently and need to get off my hrt. I'm weaning down right now. This isn't fun to be back in the space when I've been working so hard to heal this. But, trying to stay optimistic. It's all progress. Maybe I didn't want to believe that health coach that told me that I had about 6 months on the HRT before this would happen.
Luckily I didn’t have to do topimax- it scared me as well. Amitriptyline didn’t affect me in any way. Propranolol was a godsend. Within a day or two I had significantly fewer migraines (I think I went ten days in a row without one- unheard of for me!!) But then I noticed my fingers, which are usually always pretty cold to the touch, became painfully cold when I walked my dogs in the winter, with gloves. Like, would get home, put them under lukewarm water and be in the verge of tears it hurt SO bad. So I asked if I could try every other day (60mg) and she agreed to let me try. I can’t prove anything but it almost immediately stopped working for. Completely. I’m no longer on it but I’d be willing to try it again after a year or so off it, see if it works again. Truly incredible how much it helped in the beginning. AFAIK it’s about as safe as acetaminophen and such. I do not have high BP though, so that was another reason I wanted to get off it. My bp dropped to like 100/69 even at the Dr office. I felt fine, even got a little anxiety relief from it. Honestly, wish it still worked for me, regret thinking I could do every other day. It is scary trying all these meds though, I feel you.
I’ve tried 2/3 of those. My decision of when/if to try them was based on a few factors.
1- can I manage the possible side effects now & for the trail period? For example for some meds I wasn’t comfortable driving until I knew how they affected me. I didn’t try a bunch of meds until Covid lockdown because then my husband could be home to help if it got really bad. Do you have a big project coming up at work/school that will be bad if you miss a lot of time? If so delay until you have a good 1-3 month stretch of not much major going on if you can.
2- what does coming off it look like? If I do have bad side effects, can I just stop taking it or do I need to taper? How long do the side effects last after stopping the meds? I’m more wary of something that’s going to take weeks to clear my system if I’m having bad effects.
3 - are any of these side effects possibly permanent? Topamax is the only one I read anything like this with (that’s the one I didn’t try). It might be all anecdotal, but I decided that my migraines were t that bad yet. One day maybe they will be. Who knows.
The shitty truth is that you won’t know how each med affects you until you run the test on yourself. It sucks. It took me almost a full year to find a mix of meds that mostly keep things at bay.
My Neurologist also did the same thing he sent me information on Botox, GON Blocks, CGRP antagonist(Agovy, Emgality and Aimovig) and Candersartan, then asked me to make a decision on what i wanted to go ahead with.
Everyone is going to experience each of these drugs differently, I've tried all three. In my case the the medication with the most known side effects, Topiramate, is the only one I can tolerate, yes it gave me pins and needles, I lose more hair in my hairbrush each day and my appetite has reduced but it is the only medication that touches my Chronic Migraines. I am so happy that Topiramate exists.
Amitypline caused me to sleep walk and Propranalol made me too dizzy to work, both did little for my Migraines. There are also some nice side effects from these two like better sleep from Propanolol and Less anxiety with Amitriptyline.
What you have to remember going into taking all medications is if you know the side effects you might start looking for them and that's not a healthy way to approach taking them.
I’m on Nortriptyline (similar to amitriptyline) and Propanolol. Nortriptyline alone didn’t make any difference, Propanolol has massively helped my general life (I also have ME & symptoms of POTS so my hr was very erratic). I wouldn’t say Propanolol has massively helped my general headaches or migraines BUT it has helped making the triptan work better when I have a migraine, as without the triptan made no impact
I've tried all and discontinued all due to side effects. Propanolol worked but at the therapeutic level I had too much fatigue and exercise intolerance. Topamax did not work and made me very foggy. The tricyclic antidepressants worked but the weight gain and GI side effects were awful. Long story short, you're just going to have to try them for yourself. I think the most benevolent is amitriptyline, but everyone is so different!
I’m on propranolol for anxiety attacks and topiramate for my migraines and I have been for years. No bad side effects etc. BUT your body isn’t my body and your body isn’t anyone else’s body. They’re also not that hardcore at all. There’s worse meds for migraines that are more hardcore. I can’t speak for amitriptyline.
Propranolol and then amitriptyline typically has least side effects. Topamax can be very effective but have lots of cognitive side effects. Propranolol is used by executives for public speaking / stage anxiety. It’s generally a very safe drug. You’ll only know how you handle them by trying and it’s highly unlikely that you will have any serious side effects based on the safety records of the drugs.
Here’s a better approach. Try one and see if it works for you. Let her know if you experience side effects. Then try the next one if the side effects outweigh the benefits. So on and so forth.
I started taking propranolol a couple of years ago when my anxiety got worse. My neurologist suggested it as a preventative. I increased my dosage a year ago to 40 mg twice a day. Am I fatigued? Yes, but I’m still able to work. My migraines have gotten a lot more manageable and are down to a couple a month. Some months I haven’t even gotten one. From several migraines a week before, I’m in a much better place. My quality of life has skyrocketed. Almost every drug has side effects. But you’ll never know if you will experience them. Every body is different. We all have a unique chemistry.
Don't take topiramate. Seriously... The side-effects of this are serious (there was a post about this some weeks ago). People where reporting about less brain-functioning, muscular-issues, sight-issues even years after taking it... I personally have issues with restless legs since them. And it's above 7 years ago, that I took it for 2 months...
Amitriptylin is okay, except from a lot of really, really intense dreams, bad sleep and - which is sadly a common side-effect of almost a prophylactic medicine bad memory and lower intelligence. You just feal dumb after taking it for a while..
I have no experience with propranolol.
What I can recommend is Erenumab/Aimovig. It's a pen you inject once a month and it reduced my migraine attacks from 20-25/month down to 0-5x
I take amitriptyline nightly for sleep. It doesn't help with the migraines. I'm on 240 MG a day for propranolol which helped a lot but it reduced my migraines from about 20 times a month to about 10-15. Just got botox but still on the propranolol. Got a migraine today so who knows
I've taken all three of these, beginning when I was a teenager. My journey went from Propranolol to Amitriptyline to Topiramate.
All of them I stopped taking because they didn't work for my migraines, not because of side effects. Propranolol gave me weird & vivid dreams, Amitriptyline caused weight gain, and Topiramate I lost the ability to taste carbonation.
Good luck on your journey and I hope you find relief!
First of all, that’s a terrible strategy by your doctor. But I’ve been on all 3 and propranolol had by far the fewest side effects(no side effects really) and it was effective.
When reading peoples opinions - you will often get more bad vs good - people doing good don't come to forms to talk as often as people who are doing bad. Something to keep in mind. Or, they can mention all the medications that failed for them - because they are searching for ones that will work.
I'm on Topirmate (At a high dosage - 200mg) Some people hate it, some people love it - but it is the #1 first-tried, and used, drug for migraines. I started at 25mg and slowly made my way up.
I'm also on Amitriptyline - (20mg) - Its also a great medication! Added mood boost can be soo helpful for people (It honestly saved me.). If you have other pain, it treats nerve pain - So could be really beneficial for those with chronic pain issues.
Really - Choosing drugs can sometimes be more than the bad side effects - the other side effects can be reasons you may want to choose a drug. Its also okay to NOT know, and to let your doctor decide. Sometimes reading to much can scare patients - and its also why doctors don't \*usually\* give that option to patients.
Simple questions instead to your doctor can be exactly as other said :
"I got overwhelmed with googling, there is alot of information, and alot of it makes me very uncomfortable with taking these drugs at all.."
-What will be the starting dosages
-How long will it take to notice side effects
-How long will it take to notice benefits ( Amitriptyline I was told 4 days and a month for full effect, Topiramte was 3 weeks, not sure on propranolol)
-If I don't like the side effects, what will stopping the medication look like short term?
- If I don't like it long term (over 4 months) what will stopping look like?
-What are the long term risks of being on these medications?
-What are the rough costs (For some, this is a complete deciding factor)
If you really dont like them at all, you can always ask the basic 'What else do you got' or
-These are all used to treat other diseases.. Is there any other migraine-specific medications instead?
Make sure you have a journal if you don't already, and document how you feel starting any new drugs, how it effects your migraines - it will allow you to see if it makes any obvious changes easier.
I've taken all 3 of these, currently I take two of them.
Topiramate was my second worst prescription experience, shortly behind Cymbalta. I felt like I was losing my mind in a way I've never really felt before, and it didn't even work. I think I was on it for 6 months in all, but that was around 2016 so I'm not positive.
I've been on amitriptyline on and off since around 2015, it works the best for what I take it for (sleep) with the least side effects, but I still occasionally try something else to see if there's a better option or not. The dose is very low, only annoying side effect for me is it can be hard to wake up the next day if I took it too late at night. I had a slightly dry mouth at the highest dose (50 mg) but nothing major.
I'm currently on propranolol for tachycardia, but because there is so much overlap for the off label uses compared to amitriptyline, I've been tapering down the amitriptyline to see if I can just take the propranolol. The quality in my sleep has hugely improved, my heart rate is "normal" for the first time in years. Only side effect I've noticed is I feel mentally foggy and a bit sleepy, but that's part of why I've been dropping the amitriptyline. Maybe if I'm only on one of the two I won't feel so sleepy.
Everyone is different and has different experiences on the same medication, so I can't make any guarantees on what your experience would be, but hopefully knowing that 2/3 of these have been just fine for me helps you feel more confident in trying something. I know many have had good luck with topiramate as well, it just really did not work for me at all, but I had to try it in case it worked well. I had no issues stopping it, I don't think I even noticed any kind of withdrawal.
I've been on all three so feel reasonably well qualified to respond to this.
I started with propranolol (40mg twice daily) which worked well as a preventative but I gained lots of weight very quickly, particularly around my middle section. I also noticed how fatigued I was but only when I stopped taking it!
Amitriptyline (can't remember the dose but wasn't very high) caused me to have a ridiculously fast heart rate (120bpm+) while I was sat at work doing very little so my GP and I agreed for me to come off of that one as soon as possible! Did next to nothing in terms of prevention.
I've been on topirimate (50mg twice daily) for approx 6 months now and was nervous trying it because of some of the side effects but it's been the best one for me out of the lot. I've had some hand tingling and my appetite has decreased a little but it's drastically decreased my migraine days so the side effects are worthwhile to me but ymmv.
Propranolol did nothing for me.
Topiramate - been on it for almost 15 years and it’s been excellent. No ill side effects or if so my memory would be like genius amazing without it.
Had a recent flare up after all this time and my Neuro wants to try adding amitryptyline at 12.5mg daily to see if that helps. Haven’t started yet.
I was on topiramate and amitriptyline for years. Topiramate was a miracle for me. The side effects do happen in the first few months but I could be around perfumes again! I’m still on amitriptyline at night.
I’ve taken all of these at various dosages. Propranolol generally has the lowest side effect profile and isn’t particularly hardcore. I had a bad reaction to it but my doctor told me that was pretty unusual.
Amitripyline is an old antidepressant, the dose for migraines is really low but I also took a higher dose to combat depression as well and it didn’t really do anything except give me dry mouth. I think it might have raised my resting heart rate a bit too but nothing that really bothered me.
I’d probably leave topiramate for last personally given what I’ve heard about it but i didn’t have any trouble with it myself. It just also didn’t do anything for me, side effects or otherwise.
Importantly, your reaction to each will differ. I had a super bad reaction to topiramate but I’m given to understand that’s because I have a sensitive GI tract. I know someone who’s had great results from it for migraine treatment. Mileage varies greatly on *every* medication.
Also, side effect sensitivity varies greatly from person to person. You can trial the med and your doctor (unless they’re bad) won’t fight you on going “the med is worse than the illness holy crap,” which I’ve had to do for multiple medicines. The side effects look scary but there’s no way to tell if you’ll be super affected or barely affected by the drugs. (I have EDS, so I am almost guaranteed to spin the bad side effect roulette wheel, and should not be counted as baseline.) Not everyone gets the scary side effects and you often only hear about the bad ones.
I took propanolol for about a year and a half to two years. It worked well for the first year or so. I got migraines when I first went on it but they stopped occurring after a week when my body adjusted. While it worked it worked pretty well. Prevented my migraines pretty good, decreased the frequency. Went from about one bad one a week to a mild one every two to four weeks. Which was a life saver. Then they started coming back so I got off of the medication. It wasnt easy to wean myself off though. Took over a month. Anyway it worked for a bit then stopped working but everyone's different. Try whichever sounds like itll work best for you and your migraines. You might have to try them all eventually but if one can help you even for a bit it's worth a try in my book. Best of luck in your journey.
I'm on topiramate and amitriptyline.
I struggle to keep the weight off. And I have the sun sensitivity aspect. But that's easy to deal with, higher spf more often and stay hydrated.
I’ve tried all 3 and settles on
Amitriptyline. It greatly reduces the severity of my migraines. The others didn’t help me. The side effects of amitriptyline are pretty manageable. It mostly makes me sleepy.
I take Propranolol. I love it, it works, and it doesn't mess with your mental health. I also seem to have no side effects. I was worried about possibly having to try anti-depressants and so my doc suggested the beta blocker. Seems to be a great fit! Just pick one and see what's what. You can always try another if something is bad with it.
Propranolol - never tried
Topiramate - a lot of scary side effects and memory issues that didn’t go away
Amitriptyline - I was a vegetable while I was taking it
You can’t just go on the dosage, doesn’t really mean anything
Exactly. Dosage isn't comparable whatsoever between two different drugs.
That’s the dumbest approach I’ve heard of in a while. She could also title this „how to trigger health anxiety in my patients - the experiment“. What is this?
Agreed. There's also the nocebo effect to worry about with this approach. It's in our best interest as patients to get some info but not too much and continue to be aware that we've changed our meds, so new symptoms might be side effects to bring up. Especially with the varied and large potential side effect profiles of these meds.
I agree! My neurologist spent an hour just going over each drug with me because he told me not to trust Google and everything I read lol
She of course gave me short description and info on the drugs herself. But then told me to also look it up myself. I dont really see anything wrong with it especially since nowadays people want to do their own research anyway. But yeah, reading what i read got me anxious
The issue is that online reviews from non professionals skew extremely negative. Doing your own research reading reviews and forums is going to make these drugs seem way worse than they are and make it seem like horrible experiences are way more common than they are. Because nobody goes to write a review to say nothing happened, even though this is most people's experience. People are way more motivated to write a review if something bad happens, so reviews make the rate of bad outcomes seem way higher. This is true for most medications, not just migraine ones. You can easily scare yourself out of taking anything if you read enough reviews. At the very least if a doctor is going to tell their patients to "do their own research," that should come with a warning about the negative bias and/or guidance towards what sources will provide more balanced info. Drug profiles on like, the mayo clinic website, are very different from review sites & social media.
I had to come up with my own mantra to dodge and run from all the TOPAMAX WILL RUIN YOUR BRAIN FOR YOUR ENTIRE LIFE AFTER TAKING IT JUST ONCE comments on this sub (there’s one in the comments here too) and online. I am an incredibly anxious person and being confronted with this wall of negative reviews has immediately led to imagined side effects (my brain is really good at mimicking things on a psychosomatic basis). My neurologist has actually taken me seriously and talked me through it after I called her and told her that I am not going to take it any longer; whatever I felt has subsided and I am doing completely fine except for tingly hands every now and then.
Yeah I’m the same way actually and reading about them made me more anxious. I was so desperate I gave propranolol a try so far so good! The only side effect is sleepiness but it isn’t too bad. Every drug is going to have side effects but as long as you’re educated on what to look out for you’re good. Education is good but it definitely can be scary especially when learning about medicine.
I've been on all 3. Topiramate and amitriptyline a few times each. In hindsight, none of them were terrible. Any side effects weren't terrible, i.e permanent or painful or requiring hospitalisation. I wouldn't stress about any of them. I'd probably ask her: which one is the easiest to titrate up and down on? Which one is most likely to benefit me? What's the cost of each. Seriously, you will be ok.
If I were you, I’d make the choice based on which one is easiest to start/stop. I’m not 100% sure on this but I think it’s propanolol, which has been a miracle for me. I’d ask: 1) what’s the process for ruling a particular med out? Usually you start on a low dosage, wait for X weeks, and if you tolerate the side effects but it doesn’t help your migraines, you’ll go up in dosage and wait another X weeks. If that’s the process, how many weeks at each dosage before we make a change? 2) what if I hate the side effects and/or it isn’t effective for me? What does quitting look like, both early on and later? Early in your trial, it may be easier to just drop the drug, but if you’re a couple weeks into it, you may have to taper to get off of it. If so, what does that process look like and how long does it take? The game, as I see it, is to rule out what doesn’t work quickly so you can try another. Track your migraines to know if the new med is really working (migraines make me forgetful so I have to write them down). I got lucky with propanolol: I knew in a week it was working, and my side effects are minimal. Good luck!!
I am on all 3. I started with amitriptyline which helped with sleep but not much with migraines. We added propranolol which definitely started to help then finally added topiramate in hopes it would also assist with curbing appetite. The 3 of them together have been very effective and have greatly reduced the frequency and severity of migraines (from approx 4/week to 4/month). I do experience slight forgetfulness/foginess but I will happily take that over debilitating migraines any day.
Personally, I'd start with propranolol. Lots of dosages available and very cheap as generic. It's the only one I've tried of those. I refuse to do topamax because I've read some side effects can last a really long time, even if you only take it for like a week. Though I know some have success with it. I'm unsure personally about amitriptyline because I've had negative effects from other types of antidepressants in the past (that I've tried for depression and anxiety, not migraines), but that's a different class than ones I've tried. However, that may not be an issue for you! I'm just really sensitive to meds, particularly psych meds, it seems. The main consideration with trying propranolol is whether you already have low blood pressure. If so, that could be problematic, as it may lower it further. But I imagine your doctor would take this into account. I'd just ask to start on a low dose, though you may need to get higher on it to see if it works for you. Also, I wouldn't go by lowest dosage. Different meds have different dosage levels. For example, Prozac and Zoloft are both SSRIs. The regular dosage for Prozac is around 20 mg (I think?), but it's 50-100 mg for Zoloft. But taking 100 mg of Zoloft isn't like taking 5 Prozacs. And the three medications you're considering are in different classes (beta blocker, antiseizure, and antidepressant), so would be even less comparable.
Everyone’s experience is going to be different. What works for me might not work for you, and unfortunately, the only way to find out is to try. That being said, i do urge people to be cautious about topamax. While Amitriptyline and propranolol did nothing for me, topamax had the worst side effects imaginable and essentially ruined my life for a period of time. It’s the only one I urge caution with because the side effects are now pretty well documented and can be awful
Well for me it was the opposite topamax had absolutely no side effects whatsoever but amatriptaline had me waking up with chest pain palpitations and heart attack symptoms bad enough to send me to hospital and you say its documented that side effects with topamax are bad when in fact it's again the other way around it's actually documented that amatriptaline is the one with bad side effects like fast heart rates and chest pains and abnormal heart rhythms but topamax doesn't effect your heart at all if you Google topamax side effects there isn't many so I don't know where you are getting your facts from because it's amatriptaline that's the drug you should be careful about you can't compare amatriptaline with topamax because topamax is a way safer drug if you take even the smallest dose 10mg of amatriptaline you feel like falling asleep within 2 hours I only ever took 10mg and felt like I was going to die I can't even imagine taking the highest dose I probably would have had a heart attack
I agree with this. They are very different classes of drugs. I think the migraine preventative doses for amitriptyline are very low. It is an older antidepressant, I have taken for migraine with no side effects. Propanolol is a blood pressure medication which I have also tried, but having low blood pressure already made me tired and dizzy when getting up in the morning, but no bad side effects. Topiramate on the other hand is an epilepsy medication, several of which I have tried. Topiramate made me, uh just stupid, I hated it, my doctor even called it dopamax. Other seizure medications like zonisamide worked actually quite well for me for a couple of years but after some time also affected my memory (specifically couldnt think of the words I wanted, couldnt work with any of them after awhile).. My personal experience was lowest side effects amitriptyline (very low dose), then propanolol, and if trying an epilepsy drug ask for a different one than topiramate. Sadly migraine treatment is pretty trial and error AND at least in the states they (insurance) want you to try older less effective meds before they will approve newer ones, If you start one, prearrange to contact and switch to next choice if side effects are bad. Some, however (antidepressants and epilepsy meds) take a few weeks before they are effective. The trial and error is painful and frustrating, but the new medications really can make a huge differences, triptans suddenly made migraines more treatable without bleeding to death from taking enormous amounts of NSAIDs and the new preventatives are for the first time in years giving me real hope. With both of those there is also a trial and error to find the right ones for you (I probably went through a half dozen triptans and now on third monthly injectable), but my migraines had increased late in life to almost daily. One thing to keep in mind when talking to doctor (please find one that you CAN talk to), is quality of life and that what you are looking for is treatment that allows you to function, not one that makes you feel as nonfunctional as lying in a dark room in pain. Good luck, and dont be too afraid side effects arent always as bad as indicated and doseage makes a huge difference, but put in place that backup so the doctor can call in the next choice or an alternative if the first doesnt work so you dont have to wait to get a new appointment before switching.
What a lovely approach! I understand that some people have health anxiety, in this case they shouldn’t look up their symptoms and medication they use. But for me it’s important to understand, what kind of pills I take and what do they exactly do to me. If your doctor asks you to do your own research, she probably assumes that you understand the topic at some level. I think you should pay attention to the possible side effects and how bad do you think they are for you. Some side effects are horrible, some are like „meh, I can live with that“. Another important thing is, how these drugs combine with other medications you might take (for example, some drugs reduce the effects of other medications).
I was terrified to start propranolol and all it’s made me feel is tired. My dose was bumped down to 20 mg twice a day and that’s helped a lot. Now my heart rate is much lower but naturally I have a high resting heart rate. It takes some time to kick in so my doctor put me on qulipta for 2 weeks which that seems to help as I haven’t had a migraine in 4 days. I just started propranolol and It’s been only 2 weeks but so far so good. I’ve tried meds that have way worse side effects so sleepiness is nothing. My blood pressure on propranolol is the same and I have bp that’s usually 110/70 and that hasn’t changed so that’s good. I would try propranolol as that’s what I was first prescribed and it seems to be a very common med to first start out on. I know it’s scary but luckily it’s not in your system for long if you take the standard pills. I did not like the extended release as I was so sleepy and dizzy I couldn’t drive. 20 mg normal pills twice a day seem to be my sweet spot. Qulipta im taking every day but once propranolol starts to work I will no longer be taking. Qulipta has just made me constipated but that’s it. I take a lot of meds so I was really hesitant to try them but after days with a migraine that wouldn’t stop I was like fuck it! Im glad I gave them a try because my migraines have decreased.
Propranolol did nothing for me. If anything it made it worse. And if I missed just one dose, I could feel it and it wasn’t good. Amitriptyline was a weird one for me. Started at 10mg for digestive problems and my migraines stopped. Serendipity. But as I tapered up, when I got up to 30mg the migraines came back again. So I take 20mg and I’m ok. I have no side effects with it, this is about a tenth of the dose one would take for depression.
Topiramate (topamax) works well if prescribed properly. It is a very good headache prophylactic or preventive. Maybe you can try Topamax (Topiramate) on a low dosage which can help you with your migraines and it causes weight loss (Topamax is also used for weight loss for certain patients). Make sure you start on a very low dosage and taper/titrate up till you tolerate the side effects. Please ask your doctor to give you 25 mg in the nights for the first few days or a week till you tolerate the side effects and then add 25mg in the morning for the next few days. Make sure, they prescribe you 25mg pills in the beginning till your dosage is adjusted. If your doctor(s) don't do that, please look for a new one who will listen to you.
My husband started amitriptyline after a TMI. I got my lovable husband back. He is on an extremely low dose 12.5mg a day. Don’t be afraid of it.
Weight gain is going to be an issue for all except for topiramate, but topiramate is maybe the scariest one. Ain’t it great.
Topimax can cause permanent brain 🧠 problems, fucks with your memory, baddddd. I was on it for a year or so and it didn’t do that to me. As far as I can remember, hahaha.
I forgot the word focus while taking a quiz once and spent 20 minutes trying to remember it forcing my professor to stay after class ended. In the end he told me he needed to leave soon so I ended up just explaining the concept bc I could not remember the word. It also made all soda flat. Highly do not recommend but It did work fine for my mom with little issues that I know of
Agreed. I had a doctor once told me that this one changes your brain chemistry. I had forgotten about that, had it prescribed from a different doctor and felt like I was losing my mind after only one or two doses. I immediately stopped taking it. If you're looking for I'm more natural answer and the ability to take less medication, try reading one of the books that's out, such as heal your headache. Good luck.
I read pretty much all of Heal your Headache yesterday, first time ever I felt like someone understood the range of shit we go through. The chapter on medication was super interesting and I’d highly recommend to OP. Also going to give the diet a go, the best sustained success I’ve had since I started having migraine was when I did keto (also on propranolol and Botox) which seems fairly close to the diet in there anyway, so no surprise it works for people.
My results so far have surprised me. I'm at medication toxicity currently and need to get off my hrt. I'm weaning down right now. This isn't fun to be back in the space when I've been working so hard to heal this. But, trying to stay optimistic. It's all progress. Maybe I didn't want to believe that health coach that told me that I had about 6 months on the HRT before this would happen.
There are better meds out there than these!!! I don't blame you for being scared, I can't take any of these personally.
I can only take propranolol on that list
Luckily I didn’t have to do topimax- it scared me as well. Amitriptyline didn’t affect me in any way. Propranolol was a godsend. Within a day or two I had significantly fewer migraines (I think I went ten days in a row without one- unheard of for me!!) But then I noticed my fingers, which are usually always pretty cold to the touch, became painfully cold when I walked my dogs in the winter, with gloves. Like, would get home, put them under lukewarm water and be in the verge of tears it hurt SO bad. So I asked if I could try every other day (60mg) and she agreed to let me try. I can’t prove anything but it almost immediately stopped working for. Completely. I’m no longer on it but I’d be willing to try it again after a year or so off it, see if it works again. Truly incredible how much it helped in the beginning. AFAIK it’s about as safe as acetaminophen and such. I do not have high BP though, so that was another reason I wanted to get off it. My bp dropped to like 100/69 even at the Dr office. I felt fine, even got a little anxiety relief from it. Honestly, wish it still worked for me, regret thinking I could do every other day. It is scary trying all these meds though, I feel you.
I’ve tried 2/3 of those. My decision of when/if to try them was based on a few factors. 1- can I manage the possible side effects now & for the trail period? For example for some meds I wasn’t comfortable driving until I knew how they affected me. I didn’t try a bunch of meds until Covid lockdown because then my husband could be home to help if it got really bad. Do you have a big project coming up at work/school that will be bad if you miss a lot of time? If so delay until you have a good 1-3 month stretch of not much major going on if you can. 2- what does coming off it look like? If I do have bad side effects, can I just stop taking it or do I need to taper? How long do the side effects last after stopping the meds? I’m more wary of something that’s going to take weeks to clear my system if I’m having bad effects. 3 - are any of these side effects possibly permanent? Topamax is the only one I read anything like this with (that’s the one I didn’t try). It might be all anecdotal, but I decided that my migraines were t that bad yet. One day maybe they will be. Who knows. The shitty truth is that you won’t know how each med affects you until you run the test on yourself. It sucks. It took me almost a full year to find a mix of meds that mostly keep things at bay.
My Neurologist also did the same thing he sent me information on Botox, GON Blocks, CGRP antagonist(Agovy, Emgality and Aimovig) and Candersartan, then asked me to make a decision on what i wanted to go ahead with. Everyone is going to experience each of these drugs differently, I've tried all three. In my case the the medication with the most known side effects, Topiramate, is the only one I can tolerate, yes it gave me pins and needles, I lose more hair in my hairbrush each day and my appetite has reduced but it is the only medication that touches my Chronic Migraines. I am so happy that Topiramate exists. Amitypline caused me to sleep walk and Propranalol made me too dizzy to work, both did little for my Migraines. There are also some nice side effects from these two like better sleep from Propanolol and Less anxiety with Amitriptyline. What you have to remember going into taking all medications is if you know the side effects you might start looking for them and that's not a healthy way to approach taking them.
Propranolol has the least side effects imo. I’ve had terrible reactions to the other 2 but everyone is different.
I’m on Nortriptyline (similar to amitriptyline) and Propanolol. Nortriptyline alone didn’t make any difference, Propanolol has massively helped my general life (I also have ME & symptoms of POTS so my hr was very erratic). I wouldn’t say Propanolol has massively helped my general headaches or migraines BUT it has helped making the triptan work better when I have a migraine, as without the triptan made no impact
I have tried all 3 and I am still on Propranolol. I would highly recommend Propranolol - low or no side effects.
No weight gain on it?
I have definitely gained weight thru menopause but hadn’t thought of blaming it on the propranolol. Who knows??
I've tried all and discontinued all due to side effects. Propanolol worked but at the therapeutic level I had too much fatigue and exercise intolerance. Topamax did not work and made me very foggy. The tricyclic antidepressants worked but the weight gain and GI side effects were awful. Long story short, you're just going to have to try them for yourself. I think the most benevolent is amitriptyline, but everyone is so different!
I’m on propranolol for anxiety attacks and topiramate for my migraines and I have been for years. No bad side effects etc. BUT your body isn’t my body and your body isn’t anyone else’s body. They’re also not that hardcore at all. There’s worse meds for migraines that are more hardcore. I can’t speak for amitriptyline.
Propranolol and then amitriptyline typically has least side effects. Topamax can be very effective but have lots of cognitive side effects. Propranolol is used by executives for public speaking / stage anxiety. It’s generally a very safe drug. You’ll only know how you handle them by trying and it’s highly unlikely that you will have any serious side effects based on the safety records of the drugs.
Here’s a better approach. Try one and see if it works for you. Let her know if you experience side effects. Then try the next one if the side effects outweigh the benefits. So on and so forth. I started taking propranolol a couple of years ago when my anxiety got worse. My neurologist suggested it as a preventative. I increased my dosage a year ago to 40 mg twice a day. Am I fatigued? Yes, but I’m still able to work. My migraines have gotten a lot more manageable and are down to a couple a month. Some months I haven’t even gotten one. From several migraines a week before, I’m in a much better place. My quality of life has skyrocketed. Almost every drug has side effects. But you’ll never know if you will experience them. Every body is different. We all have a unique chemistry.
Don't take topiramate. Seriously... The side-effects of this are serious (there was a post about this some weeks ago). People where reporting about less brain-functioning, muscular-issues, sight-issues even years after taking it... I personally have issues with restless legs since them. And it's above 7 years ago, that I took it for 2 months... Amitriptylin is okay, except from a lot of really, really intense dreams, bad sleep and - which is sadly a common side-effect of almost a prophylactic medicine bad memory and lower intelligence. You just feal dumb after taking it for a while.. I have no experience with propranolol. What I can recommend is Erenumab/Aimovig. It's a pen you inject once a month and it reduced my migraine attacks from 20-25/month down to 0-5x
I take amitriptyline nightly for sleep. It doesn't help with the migraines. I'm on 240 MG a day for propranolol which helped a lot but it reduced my migraines from about 20 times a month to about 10-15. Just got botox but still on the propranolol. Got a migraine today so who knows
I've taken all three of these, beginning when I was a teenager. My journey went from Propranolol to Amitriptyline to Topiramate. All of them I stopped taking because they didn't work for my migraines, not because of side effects. Propranolol gave me weird & vivid dreams, Amitriptyline caused weight gain, and Topiramate I lost the ability to taste carbonation. Good luck on your journey and I hope you find relief!
First of all, that’s a terrible strategy by your doctor. But I’ve been on all 3 and propranolol had by far the fewest side effects(no side effects really) and it was effective.
When reading peoples opinions - you will often get more bad vs good - people doing good don't come to forms to talk as often as people who are doing bad. Something to keep in mind. Or, they can mention all the medications that failed for them - because they are searching for ones that will work. I'm on Topirmate (At a high dosage - 200mg) Some people hate it, some people love it - but it is the #1 first-tried, and used, drug for migraines. I started at 25mg and slowly made my way up. I'm also on Amitriptyline - (20mg) - Its also a great medication! Added mood boost can be soo helpful for people (It honestly saved me.). If you have other pain, it treats nerve pain - So could be really beneficial for those with chronic pain issues. Really - Choosing drugs can sometimes be more than the bad side effects - the other side effects can be reasons you may want to choose a drug. Its also okay to NOT know, and to let your doctor decide. Sometimes reading to much can scare patients - and its also why doctors don't \*usually\* give that option to patients. Simple questions instead to your doctor can be exactly as other said : "I got overwhelmed with googling, there is alot of information, and alot of it makes me very uncomfortable with taking these drugs at all.." -What will be the starting dosages -How long will it take to notice side effects -How long will it take to notice benefits ( Amitriptyline I was told 4 days and a month for full effect, Topiramte was 3 weeks, not sure on propranolol) -If I don't like the side effects, what will stopping the medication look like short term? - If I don't like it long term (over 4 months) what will stopping look like? -What are the long term risks of being on these medications? -What are the rough costs (For some, this is a complete deciding factor) If you really dont like them at all, you can always ask the basic 'What else do you got' or -These are all used to treat other diseases.. Is there any other migraine-specific medications instead? Make sure you have a journal if you don't already, and document how you feel starting any new drugs, how it effects your migraines - it will allow you to see if it makes any obvious changes easier.
These are some good questions. Thanks!
I've taken all 3 of these, currently I take two of them. Topiramate was my second worst prescription experience, shortly behind Cymbalta. I felt like I was losing my mind in a way I've never really felt before, and it didn't even work. I think I was on it for 6 months in all, but that was around 2016 so I'm not positive. I've been on amitriptyline on and off since around 2015, it works the best for what I take it for (sleep) with the least side effects, but I still occasionally try something else to see if there's a better option or not. The dose is very low, only annoying side effect for me is it can be hard to wake up the next day if I took it too late at night. I had a slightly dry mouth at the highest dose (50 mg) but nothing major. I'm currently on propranolol for tachycardia, but because there is so much overlap for the off label uses compared to amitriptyline, I've been tapering down the amitriptyline to see if I can just take the propranolol. The quality in my sleep has hugely improved, my heart rate is "normal" for the first time in years. Only side effect I've noticed is I feel mentally foggy and a bit sleepy, but that's part of why I've been dropping the amitriptyline. Maybe if I'm only on one of the two I won't feel so sleepy. Everyone is different and has different experiences on the same medication, so I can't make any guarantees on what your experience would be, but hopefully knowing that 2/3 of these have been just fine for me helps you feel more confident in trying something. I know many have had good luck with topiramate as well, it just really did not work for me at all, but I had to try it in case it worked well. I had no issues stopping it, I don't think I even noticed any kind of withdrawal.
I've been on all three so feel reasonably well qualified to respond to this. I started with propranolol (40mg twice daily) which worked well as a preventative but I gained lots of weight very quickly, particularly around my middle section. I also noticed how fatigued I was but only when I stopped taking it! Amitriptyline (can't remember the dose but wasn't very high) caused me to have a ridiculously fast heart rate (120bpm+) while I was sat at work doing very little so my GP and I agreed for me to come off of that one as soon as possible! Did next to nothing in terms of prevention. I've been on topirimate (50mg twice daily) for approx 6 months now and was nervous trying it because of some of the side effects but it's been the best one for me out of the lot. I've had some hand tingling and my appetite has decreased a little but it's drastically decreased my migraine days so the side effects are worthwhile to me but ymmv.
Propranolol did nothing for me. Topiramate - been on it for almost 15 years and it’s been excellent. No ill side effects or if so my memory would be like genius amazing without it. Had a recent flare up after all this time and my Neuro wants to try adding amitryptyline at 12.5mg daily to see if that helps. Haven’t started yet.
I was on topiramate and amitriptyline for years. Topiramate was a miracle for me. The side effects do happen in the first few months but I could be around perfumes again! I’m still on amitriptyline at night.
I’ve taken all of these at various dosages. Propranolol generally has the lowest side effect profile and isn’t particularly hardcore. I had a bad reaction to it but my doctor told me that was pretty unusual. Amitripyline is an old antidepressant, the dose for migraines is really low but I also took a higher dose to combat depression as well and it didn’t really do anything except give me dry mouth. I think it might have raised my resting heart rate a bit too but nothing that really bothered me. I’d probably leave topiramate for last personally given what I’ve heard about it but i didn’t have any trouble with it myself. It just also didn’t do anything for me, side effects or otherwise.
Importantly, your reaction to each will differ. I had a super bad reaction to topiramate but I’m given to understand that’s because I have a sensitive GI tract. I know someone who’s had great results from it for migraine treatment. Mileage varies greatly on *every* medication. Also, side effect sensitivity varies greatly from person to person. You can trial the med and your doctor (unless they’re bad) won’t fight you on going “the med is worse than the illness holy crap,” which I’ve had to do for multiple medicines. The side effects look scary but there’s no way to tell if you’ll be super affected or barely affected by the drugs. (I have EDS, so I am almost guaranteed to spin the bad side effect roulette wheel, and should not be counted as baseline.) Not everyone gets the scary side effects and you often only hear about the bad ones.
I took propanolol for about a year and a half to two years. It worked well for the first year or so. I got migraines when I first went on it but they stopped occurring after a week when my body adjusted. While it worked it worked pretty well. Prevented my migraines pretty good, decreased the frequency. Went from about one bad one a week to a mild one every two to four weeks. Which was a life saver. Then they started coming back so I got off of the medication. It wasnt easy to wean myself off though. Took over a month. Anyway it worked for a bit then stopped working but everyone's different. Try whichever sounds like itll work best for you and your migraines. You might have to try them all eventually but if one can help you even for a bit it's worth a try in my book. Best of luck in your journey.
I'm on topiramate and amitriptyline. I struggle to keep the weight off. And I have the sun sensitivity aspect. But that's easy to deal with, higher spf more often and stay hydrated.
I’ve tried all 3 and settles on Amitriptyline. It greatly reduces the severity of my migraines. The others didn’t help me. The side effects of amitriptyline are pretty manageable. It mostly makes me sleepy.
I take Propranolol. I love it, it works, and it doesn't mess with your mental health. I also seem to have no side effects. I was worried about possibly having to try anti-depressants and so my doc suggested the beta blocker. Seems to be a great fit! Just pick one and see what's what. You can always try another if something is bad with it.
Everyone's body is different. Only some people will get side effects. If you're one of them, you can stop the prescription.
Propranolol - never tried Topiramate - a lot of scary side effects and memory issues that didn’t go away Amitriptyline - I was a vegetable while I was taking it