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Seizures and Migraines

I have suffered from migraines since I was 12 years old. A couple of years ago I suffered seizure as a result of a high fever. After the seizure I started Topamax which helped my migraines and as a seizure prophylactic. However, now I have to take a heavy duty seizure med (Lamictal) along with the Topamax to control any possible seizure. This has resulted in chronic migraines. I currently take Topamax and propranolol as preventatives along with Relpax as the rescue med when the migraine hits. My neurologist now wants me to take Pristiq (anti-depressant/SSNI) as another preventative measure. I already suffer from MOH. I'm worried that adding this medication could result in serotonin syndrome - something my neurologist never mentioned. She has a tendency to throw any new meds at the problem. Does anyone have experience with Pristiq and or these issues? Thanks in advance for any comments!

  1. dcristi,

    How frequently are you taking Relpax? Is that what's causing the MOH, or are you taking something else as well?

    Your concern about serotonin syndrome (SS) is one I hope you'll discuss with your doctor. SS is actually pretty rare, but we do need to be aware of the possible symptoms and, of course, explore the concerns fully.

    I use Zomig as my abortive medication (triptans such as Relpax and Zomig are abortive medications, not rescue medications) and use venlafaxine XR (Effexor XR) for depression and Migraine prevention and haven't had any symptoms of SS. I haven't used Pristiq, but venlafaxine is also ans SNRI antidepressant.

    An additional issue regarding MOH is the possibility that at least some preventives may not be effective if we're having MOH. So far, studies have shown that Topamax and Botox may work, but the jury is still out on the issue overall.

    Here's an article that explains the different types of Migraine medications --

    Migraine Preventive, Abortive, and Rescue Medications

    Hope this helps,

    1. Thank you Teri for all your information. My neuro is the one that told me Relpax was a rescue med. I agree it's seems to be an abortive med as I use it when I'm in the beginning stages/full blown migraine. I also take a pain med with the Relpax. I have done a bit more research on SS and have decided to try the Pristiq. I'm hoping it will not only help with the migraines but also with fatigue and depression. I will let you know if I have any positive results. Thank you so much for your help.

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