72. How To Get Off Your Migraine Meds

You're on multiple preventatives. Brain fog, hair loss, exhausted all the time. You feel "stable" but not good. You tell your neurologist you want to come off one.

They say: "Cut it in half for a week, quarter it for another week, stop in two weeks."

You follow their advice. Two weeks later? Massive migraine flare that lasts five days. You're back in their office. They shrug: "Well, what did you expect? I guess you need the medication."

So you think: I guess I'm stuck on this forever.

Here's the truth: Nobody has a Topamax deficiency. You weren't born needing it.

Dr. Leslie has walked hundreds of clients through weaning off Topamax, propranolol, gabapentin, nortriptyline, even antipsychotics and anti-seizure meds.

If you try to come off preventatives while still getting 10 migraines a month, it won't go well, even with a slow wean.

Dr. Leslie breaks down the two critical factors for successfully coming off preventatives: timing (your health must be restored first so migraine frequency drops significantly) and the correct wean-off approach (not your neurologist's rushed 2-week plan).

Watch the full episode to learn exactly how to set yourself up for success.

After watching, check out these related episodes:

Migraine Rebound Episode - Understanding why taking too many medications keeps you stuck in the cycle: Watch Here

Free Training: Why Medications Stop Working

Schedule your free consultation with Dr. Leslie: https://www.drlesliecisar.com/apply

Free Training: 5 Proven Steps to Being Migraine Free (Even if you think you've already tried everything.)

https://www.drlesliecisar.com/5SHMN

Connect with us:

Website: https://www.drlesliecisar.com/

Free Facebook Group: Healing Migraines Naturally, with Leslie Cisar, ND

Ready to try something radically different that actually works? Read more about my approach here: https://www.drlesliecisar.com/map

Episode Transcript

welcome to the Healing Migraines Naturally podcast
I'm your host Doctor Leslie Caesar
and I am a licensed naturopathic doctor
and I work with women all over the country
who have chronic migraines
who Wanna stop having chronic migraines
they wanna get off their medication
and they wanna do it without having to take fistfuls
of supplements to boot
so welcome to the podcast
today our episode is called
help I can't get off my preventative meds
so this is a really important topic
that we really haven't talked a lot about
on the podcast yet
and so
I'm really excited to talk about it with you today
so first of all preventative migraine medication
what is preventative migraine medication
so this is medication that is taken daily
in the hopes of
lowering
the frequency and severity of the migraine flares
so that you don't have to take as much
abortive medication right
so abortive medication is medication that you take to
quote unquote make the migraine go away
and so that is medication that's taken as needed
when the migraine symptoms start to flare
and preventative medication is taken daily
whether you have a migraine or not
maybe you know
you feel pretty good today
you're still going to take that preventative medication
because the preventative medication
the theory behind that
is that it's going to lower the frequency
of the migraine flares
and then the severity of the migraines themselves
when they do happen so the expectation
when someone takes preventative medication
so like a lot of drug
advertisements
are around migraine preventative medication
so like I like to watch a lot of HGTV shows
like those house flipping shows
I really like those shows
so I watch a fair amount of HGTV programming
and obviously that channel appeals more to women
I'm sure than men
and women are much more prone to migraines than men
and so whenever I watch a HGTV
I see a lot of migraine pharmaceutical advertising
and that's generally for migraine preventative
medication right
and so when they kind of go through
like the verbal fine print right
they talk about like
how great your life is gonna be on this medication
and then the lady comes in
and starts talking real fast about how
it causes these side effects and
you know everything else
that little verbal fine print
you know they will say
a lot of the advertisements will say something like
you know you know
patients that took Brelvi experienced
a 50% reduction in their migraines right
and so in conventional medicine
a 50% reduction in symptoms
so like if somebody went from 20 migraines a month
to 10 migraines a month
that would be like a 50% reduction
that would be considered a tremendous success right
that's like a blockbuster medication right
now
when we are actually looking at the human suffering
here
we've gone from two thirds of the month with a migraine
which is horrible
to one third of the month with a migraine
which is still horrible right
so the definition of success within like
conventional medicine the pharmaceutical industry
what's considered like a breakthrough
is a little bit different than what we actually want
right
we don't want to spend any days with a migraine right
the goal of preventative medication is not that you
never have another migraine
it's that the migraine frequency
the migraine severity is less
and then you're still going to be taking
your abortive medication on top of that
when you have a migraine right
so if I have 20 migraines per month well
now I'm running into a problem
because I can't take 20 Imitrex a month right
one of the most common frontline
abortive medication for migraines
that prescription that I'm gonna get for that
is only gonna be nine to 12 tablets
per month right
so if I have 20 migraines a month uh oh
now I have a problem right
so now I'm gonna be in that horrible place
that a lot of my clients have been in
where it's like uh oh
I only have 12 this month
I know I'm probably gonna have 20 to 25 so my you know
uh oh I can feel it brewing
I can feel something starting here
how bad do I think this is gonna get right
we do like the the head check right
how bad is this one probably gonna get
what because we get kind of tuned in right
is this gonna be a really bad one
is this gonna be more of a mild one
that I can just kind of white knuckle my way through
we develop that kind of sense right
so we kind of go through this whole thing
is this gonna be a bad one
what do I have going on later today
if I really don't have that much going on
maybe I'll just suffer through
is it gonna be worth it to waste an imetrex on this one
right cause I don't wanna take an imetrex
if it's really not gonna be that bad
because I only have 12
and I know I'm gonna need 20 for the whole month
so I don't wanna waste
my imetrex on one that isn't gonna be that bad
so I gotta spend a couple hours thinking about that
how bad do I think this is gonna be
do I is this worth it to waste it
what do I have coming up you know
maybe this weekend right
so maybe I got this big thing this weekend
and it's Tuesday so maybe I just suffer
you know Tuesday and Wednesday and Thursday
because then I'll have you know
I won't have kind of burned through or wasted
my imitrex and then I can use it this weekend right
anybody going through this right
it's this exhausting calculation and mental
you know gymnastics
do I wanna take one of my abortives for this or not
right so when people get into that situation right
when they're the frequency of their migraines
is in excess of the nine to 12 abortive
you know pills that they have per month
they go back into their doctor and they say
you know what I need more right
you're only giving me nine
I mean I'm getting 15
20 a month this isn't cutting it right
and the doctor says well
I can't give you more than nine
I can't give you more than 12
number one your insurance isn't gonna cover it
and then number two
I would be going against the prescription guidelines
so this is what a lot of people don't realize
they think that their doctor
won't increase the number of tablets per month because
like the big bad insurance company won't pay for it
there's something a little bit deeper going on here
hi there it's Doctor Leslie
if you're a woman
having eight or more migraine days a month
let's talk
I'll show you how to drop them to near zero in 90 days
without adding more medication
in fact you can even lower
or maybe even completely
wean off of your medication within 90 days
and without agonizing cold Turkey withdrawals
let me tell you about my client Judy
she was on such strong medications for her migraines
that she was nearly bedridden
and could barely function
she had to close the doors of her small business
and felt like a failure she wondered every day
why am I doomed to suffer from these migraines
but just like you
she started listening to my Healing Migraines
Naturally podcast and a spark ignited
she knew that if she could just figure out
why these migraines started in the first place
she could restore and recover her health again
so she booked her free console call with me
and the rest is history
she now goes months between migraines
and runs her small business full time again
because she's completely off of those preventative
medications she followed the 12 week plan
and got incredible results
I've worked with women just like Judy
from all over the United States
overcome migraines naturally
so if you're serious about healing your migraines
then tap the link in the description
and book a free consult call with me
just like Judy did we do cap new clients monthly
so if the calendar is full
the doors are closed for now
so don't wait to reclaim the life you deserve to live
no matter how hopeless things seem
now with expert guidance
you can heal and recover from migraines
so I look forward to chatting with you
click the link now to schedule your call
your doctor and your insurance company
doesn't want to give you more than nine to 12
per month because if you take more than that
you're going to have a high likelihood
of getting into migraine rebound
okay
so I did a whole podcast dedicated to migraine rebound
we'll link to that in the show notes
but your doctor doesn't want to give you medication
in excess and then make you suffer even more
because now you're in a migraine rebound situation
so the prescribing guidelines for triptan medication
which even with the new CGRP antagonist
oral abortive medications like nertec
still the triptan medications are still widely used
if you take more than 2 tryptans per week
you are in the danger zone
of going into migraine rebound
so your doctor doesn't want to do that to you
and the insurance company
doesn't want to pay for something
that's going to put you in a worse state
so there's a rationale behind that
a lot of people get really mad and they're like
how come I'm not being cared for
how come my pain is not being taken seriously
it's not that it's not being taken seriously
it's not that the insurance company
is just being a jerk
it's that both parties don't want to give you something
approve of something pay for something
that's going to make you even worse in the end
so once you start having more migraines than that
like 9 to 12 range per month
then your doctor's gonna say look
I can't give you more imitrex
but you know now
we've reached the point
where we need to put you on a preventative medication
and so
the point of the preventative medication is not to
completely take the migraines away
it's to lower
the frequency and severity of the migraines
so that you don't need to take as many abortive
medications
so a preventative medication
is something that you're going to take
every day regardless of how you feel
so if you wake up and you're like
oh doing my daily head check
I'm feeling pretty good right
this seems this might be a good day right
you're still going to take that preventative
migraine medication every day
and so no one wants to take medication right
you didn't want to take the abortive medications
you certainly didn't want to take
you know 12 Imatrex per month
that was the last thing you wanted to do
but you did it because what alternative did you have
you had to get through your day
you had to go to work
you had to take care of your family
you had to do what you had to do
and with any medication over time
it's going to work less and less well
and we've done several podcasts on this as well
I have a free training on this
it will link to but any medication that you take
that suppresses the symptoms
that your body is generating
your body is going to fight that
and it's going to start to generate the symptoms
more and more frequently and more and more strongly
the symptoms are gonna get worse
they're gonna get more severe
and they're gonna come more frequently
so that's why when people start
you know when people start getting migraines
usually they are getting migraines infrequently
and they're using over the counter medications
like Advil Motrin
Aleve Excedrin
just things that they're buying at CVS or Walgreens
and when the migraines first start
those over the counter medications work well enough
that people can get some relief
they can get on with their day
but because the health is continuing to decline
the body is going to make more and more migraines
and then we're suppressing the migraine symptoms
with the Excedrin or with the Advil
so then
the body starts making them more and more frequently
and more and more severely
more and more severe migraines
so then we have to move to the prescription abortives
like imitrex or nurtec and then again
it's the same phenomenon everybody knows
that the medication is not addressing the root cause
of why the body is generating the migraines
it's just suppressing the symptoms
and so the body is gonna start generating
more and more migraines and then
you reach the point where
you don't have enough abortive medication
to make it through the month
and then you have this conversation with your doctor
about going on preventative medication
so the most common
preventative migraine medications
are going to be things like Topamax
gabapentin nortriptyline
blood pressure medications
typically something like a beta blocker
like propranolol antidepressants
are sometimes used as migraine abortive medication
or migraine preventative medication
and then sometimes
people are even placed on anti seizure medication
like Keppra as a migraine preventative
or antipsychotic medication like Seroquel
sometimes those medications
are even used as migraine preventative medications
so typically one preventative will be started first
so usually people are started on either a beta blocker
like propranolol or something like Topamax
so it's usually gonna be one of those two
that people are started on first
and again for most people
if they're not experiencing
too severe side effects from
those medications if they can tolerate the medication
usually at the beginning
those preventative medications do have an effect
where the frequency and the severity of the migraines
improves so
we can go from 20 migraines a month
to 10 migraines a month
that would be considered a like a blockbuster response
very good response and then if I have 12 imatracks
I can cover that right so with preventative medication
the expectation is
you're still gonna be getting migraines
we're just gonna lower it
so that you're not having to overtake
overuse your abortive medication
but again the same phenomenon is going to occur
so what's what works in the beginning
the body is gonna fight that
so if Topamax is used at first and again
people can tolerate the side effects of
severe brain fog and their hair falling out
and their appetite tanking
and not being able to eat very much
if people aren't suffering that much from the topamax
eventually
the body is gonna fight the topamax enough where oh
now the frequency of my migraines
and the severity of my migraines has increased again
where
now I can't get by anymore with my abortive medication
right now
what used to be 10 and I used to be covered well
now it's 15 again right
and I only have 12 so now I am not covered anymore
so then
a second preventative medication is gonna be added
so I have worked with clients that are on
multiple preventative medications
I've had clients that might be on you know
four preventative medications
this in addition to migraine abortive medications
and let's face it
when people have that severe migraines
they're not just taking Imitrex as an abortive
they're taking other medications for migraine symptoms
as well so
they might be taking a anti nausea medication
like Phenergan or they might be adding on
like a Benadryl kicker to two things
they might be adding in a muscle relaxer
so by the time people have that severe
frequency and severity
they're not just taking one imitrex
they're taking an imitrex with a fenugreek
maybe a Benadryl kicker maybe a muscle relaxer on top
if it really gets bad they gotta add on a fioricet OK
that's an addition
to three to four preventative medications okay
trust me this is not that uncommon okay
when this happens to people
it's it's highly likely that they're going to be very
very foggy
so they may not be experiencing like the brutal
agonizing you know
my brain is gonna explode type of pain
but they're not feeling good on a day to day basis
they're feeling foggy
a common thing that people will say is
I feel like I got hit by a bus right
so they're feeling foggy they're very fatigued
they're having difficulty at work even at home
they're there but you know
their mood is kind of flat right
it's like kind of that spark is gone right
so they're highly medicated
to kind of keep the most severe
you know pain and nausea and so on at at bay
but they're not feeling that great
now if this is you I feel for you totally
this is no type of criticism or anything like that
I know that you got into this situation
because
you really were between a rock and a hard place right
and it was truly a matter of functioning
making it through the day keeping your job
taking care of your family or taking this medication
I know you don't want to be on for preventatives
and take this abortive medication
I totally get it right
now people are in a situation of okay
how do I get off of these things right
and so usually
people will eventually kind of reach a stable point
so alright
what used to be 25 migraines a month now with you know
this whole kind of multiple medication
we got this dialed in with the neurologist
where I'm down to you know
eight migraines a month and my abortives
you know I'm not in agonizing pain
people kind of feel like I'm stable right
I'm not great but I'm stable
and
I would love to come off of one of these preventative
medications because I'm really struggling with the
the side effects right
like I can say at at best case scenario
people feel real foggy
and they just kind of feel like they're doped up
hit by a bus at worst
people are losing their hair right
they're having difficulty sleeping
they they're digestion is poor
they're feeling really stiff
you know it's like I feel like I'm
you know 80 and I'm 40 right
so it's like how can I
now that I'm stable can I just get off one of these
right can we start to taper me off
how can I come off of these medications
so they go into their neurologist
and they have that discussion
I wanna come off of the medication
so this is what I see over and over and over again
neurologists
they are very skilled at putting people on medication
but they're not that skilled at taking people
off of medication
it's a real art form to take people off medication
so because I'm a licensed naturopathic doctor
I am medically trained
as well as trained in natural therapeutics
and this is a very important distinction that a lot of
people are not aware of so not all naturopathic doctors
or people that call themselves naturopathic doctors
are medically trained
so in half the states in the United States
anyone can call themselves a naturopathic doctor
neuropathic medicine is not regulated
in about half the states so where I live in Illinois
this is a state where The State of Illinois
does not regulate the practice of naturopathic medicine
medicine is regulated on a state by state basis
not on a federal level or a national level
and so each state
regulates the practice of conventional medicine
chiropractic acupuncture
naturopathic medicine
and so in the state of Illinois where I live
the state of Illinois doesn't regulate it
so anyone in the state of Illinois
can call themselves a naturopathic doctor
someone with absolutely no training at all
someone who did like a 6 week online course
anybody here in the state of Illinois
can call themselves a naturopathic doctor
so I was trained in the state of Arizona
which is where I did my training
where I went to naturopathic medical school
and where I practiced for 4 years
and where I can continue to hold my license
so medically trained
naturopathic doctors are eligible to be licensed
in the approximately 25 states
that license and regulate naturopathic medicine
so
in order for me to get that license in the first place
maintain my license I had to go through four years of
fully accredited by the US Department of education
and also regional accrediting bodies
of a four year residential medical education
and I also had two years of clinical training
and then
I have to do continuing education credits every year
including 10 hours of pharmaceutical
continuing education to maintain my license every year
so I am fully trained in all of these medications
in the state of Arizona
I can prescribe all of these medications
now of course
my mission
is to help people come off of their medication right
not put people on medication
but I am licensed
and able to prescribe all of that medication
because I am trained to do that
and so I have the expertise
I understand the mechanism of how the medication works
I and I also understand the prescribing guidelines
so I understand the standard of care that your doctor
your neurologist should be operating under
when they are prescribing you the medication
so I know when you tell me well
the doctor told me to take this
you know
take it like X y and Z
I know whether they're actually telling you
to take it correctly or not and
and I find this sometimes too
where people have been prescribed medication
and the doctor is not prescribing it correctly
according to standard of care guidelines
and people aren't aware of that
now because I can prescribe medication
I can take people off of medication
now when I work with my clients
I do not change anyone's prescription okay
because I'm working with people all over the country
I am not changing their medication
I'm educating them
and I'm helping them work with their prescribing doctor
it's illegal for me
since I am not their prescribing doctor
it's
would be illegal for me to change their prescription
and so I don't do that but
because I have the training and experience that I have
I can guide my clients to work with their neurologist
or their you know
their primary care physician
whoever gave them the prescription
I can educate them
and guide them on how to have that conversation
with their prescribing doctor
to come off of the medication
so
what I see over and over again is that medical doctors
because they're not that experienced
taking people off of medication
when a medication needs to be weaned off of
so these preventative medications
the typical ones that people are on
that I've used as examples here on this podcast
those medications have to be carefully weaned off
if you were to be taking Topamax every day
for five years and one day you wake up and you say
you know what I'm really tired of taking this Topamax
I'm just gonna stop it's highly
highly
likely that you're going to have severe withdrawal
effects you never want to just abruptly stop
taking a medication
most medications should be weaned off of
and frankly even medications where technically
the standard of care says that it doesn't have to
be weaned off
you might want to wean off of that medication
medical doctors they're not that skilled at weaning
people off of medication and so when the
you know
when you go into your neurologist and you're like
you know what
I'd really like to get off of this Topamax
I'm feeling pretty stable
I'm not great but I'm stable
and my hair is falling out
and I can hardly eat anything
cause my appetite is tanked and I'm so foggy
I can hardly remember where I put my car keys
I'd really like to come off this Topamax
the neurologist says well okay
if you want to you know
first of all they're
a lot of times
a little skeptical that this can even be accomplished
and so then they're like well
okay great
if you wanna try to do that
just you know
cut it in half for a week
cut it in quarter and quarter for another week
and come off of it in two weeks okay
this is a recipe for a disaster
I am not giving you medical advice on this podcast
do not change any of your medication
based on what I'm telling you on this podcast
I am trying to give you some educational information
here and give you a basic understanding
always talk to your doctor before you do anything
but that recommendation
to quickly come off of that Topamax
if you've been taking Topamax for five years
coming off of it in two weeks is
for most people going to be completely unrealistic
but this is what the doctor says
and so
the patient dutifully follows the doctor's advice
and they come off of Topamax in two weeks
and then what do you know
two and a half weeks later
they're in a massive migraine flare
they can't sleep
they're having tons and tons of bizarre symptoms
and you know
five days into a horrible migraine
they're back in the neurologist's office and they say
well you know
I weaned off of this in 2 weeks
and now I'm in a 5 day flare
now I'm in rebound cause I had to take so many abortive
my abortive medication so much
and the neurologist is like
well what did you expect right
you have a chronic condition
I guess you need the Topamax right
so
this is the No. 1 thing that people say to themselves
when they try to come off of a preventative medication
and the symptoms come roaring right back
they have horrible you know
withdrawal symptoms when they come off
the first thing everybody says to themselves is oh
I guess I needed the Topamax right
like I guess I need this is a horrible
horrible lie
so let's kind of break this down a little bit here
so first of all if we haven't done anything
to improve our overall health
before we come off of a preventative medication
what do we expect to happen okay
so again everybody
knows that the medication
is not addressing root cause issues
and it's not improving our health right
it's just
kind of masking the symptoms that we're experiencing
so first we want to improve our health
so that our body is making fewer and fewer migraines
with less and less severity of symptoms
before we even consider
touching preventative medication
so
when I have a client that's on preventative medication
and this is like
a big motivator for a lot of my clients
a lot of people reach out to me for help
because they're taking preventative medication
maybe they're already taking Topamax
their hair is already falling out
they're already totally brain fogged
the migraines are creeping up in frequency and severity
their neurologist is like okay
we need to start a second preventative
or we need to put on a third or fourth preventative
and you know it's like okay
I I gotta do something different right
because I'm already feeling doped up
now we're talking about another one
it's like I'm done right and they reach out to me
that's a big you know a big motivator for my clients
I wanna come off this preventative medication
I haven't felt good since I started taking this Topamax
you know they don't call it dopamax for no reason right
and so people are like okay
I've had enough
the last thing I want to do is add more onto this
I gotta get to the root of this right
so they start working with me
with a major goal of coming off say
the topamax now
they're already getting 10 migraines a month
with the Topamax right
and with each of those 10 migraines
they're already taking an imitrex and a Fen
maybe a Benadryl kicker on the top of that right
so we're not even gonna think about the Topamax
until that migraine frequency and severity improves
right so you
you can restore your health
and the migraine frequency and severity can improve
while you're taking Topamax
while you're taking a preventative medication
this is how I work
so we first we identify what your body needs that
you know it
our body
wants to get itself back into a state of health
our body doesn't want to generate all these migraines
it's generating it
because it doesn't have what it needs to function
properly and so when I work with my clients
the first thing that we do is
we do an assessment that identifies okay
what exactly does your body need
then we put a game plan
together to give your body what it needs
and then when that happens
your body is going to do what it is designed to do
which is restore itself back into health
into homeostasis into equilibrium
and when that happens
it's going to generate fewer and fewer migraines
less and less severe migraines
so you take your abortive medication as needed right
you you don't take Imitrex every day
you take Imitrex when the migraine comes on
you don't take phenegran with every migraine
you take the phenegran when the nausea is really bad
with any particular migraine right
you don't take the Benadryl Kicker all the time
you take the Benadryl kicker
when the pain is so bad that it
you can't sleep at night
and you want a little sedative right
so as the severity of the migraines improves right
so a migraine becomes less severe
when the pain isn't as bad
and oh you know what gosh
I used to have horrible nausea every migraine
lately I haven't been getting any nausea
so if you're not having nausea with the migraine
you're naturally not going to take that fenugreek right
if you normally have migraines that last 48 hours
but now your migraines are only lasting eight hours
and you can sleep at night
you're not gonna take that Benadryl kicker over the top
right if the migraine isn't that severe
well you know
this is more of like a nagging thing
it's not like a full blown
you know
my brain is gonna explode and I'm gonna be in bed
it's more like this nagging thing all day
well you know what
now I can take an take Advil right
so so literally right
I have clients where they're taking
you know Imitrex
Phenergan muscle relaxers right
and they naturally will gradually
sort of wean off those as needed medications
then we step them down to over the counter yeah
you know I know like a migraine suffer
if somebody says well
why don't you just take an Advil
and you just want to wring their neck right
but when we get the severity down
you don't have to take three different
abortive medications you can get by with Advil
it's wonderful
and then it continues to get less and less severe
well you know what
it kind of nagged me all day
but I really didn't even need to take an Advil
I was able to make it through
and then before you know it
you're going 3 to 4 weeks between a flare
you haven't taken an abortive medication in weeks right
so you're feeling better and better
the migraine frequency and severity has improved
now is the time to take a look at your preventative
medication you
if you come off of preventative medication
and you're still getting 10 migraines a month
what do you think is gonna happen right
it's not gonna go well
even if you wean down very slowly etcetera
we've got to get you feeling better
we've got to get that migraine frequency and severity
significantly improved and trust me
you're gonna be feeling better as a whole person also
everyone that comes to me
they're like just get my migraines gone right
I don't care that I'm not sleeping that well
I don't care that I have to get up to urinate
2 3 times in the middle of the night
I don't care that every time I get out of a chair
you know oh my my
my muscles hurt I don't care about my heartburn
just get my migraines gone
well I got news for you
all those things are going to start to improve
if we're going to make any progress
with your migraines right
because the rising tide of our health
lifts the boats
of all of the symptoms that we're experiencing
so you know
if you're going if we're going from
you know 10 migraines a month
with preventative medication on board
and you're now like getting a mild migraine
that you don't really have to take anything for
or maybe you're just taking a little Advil for every 3
4 weeks
and you're feeling better than you have in years
as a whole person now
when you said now when you say okay
let's get off the topamax right
so what I do with my clients again
because I do not change their prescriptions
they work with their prescribing doctor
to change their prescriptions
but also in my experience
I have the experience to guide people
if you're on four preventatives
which one should you wean off of first
and this is a conversation that I have found
that neurologists they really don't even think about it
right the patient kind of comes in with like oh
you know okay
I'm on you know propranolol
Topamax gabapentin
and Botox but you know
I really want to come off this Topamax first
because my hair's been falling out
ever since I started and I have horrible brain fog
right so the patient is coming in
requesting to come off of the topamax
and the neurologist is like alright
we'll give it a shot 2 weeks
right whatever
but that may or may not be the best medication
for you to come off of first
and this is again where my expertise comes in
you might be
better off coming off of the propranolol first
this is something where
because I know my client so well by this point
I know how their body reacts
and I know what their symptoms are
and I know because I am medically trained
if we are dealing with side effects
what side effects
are more likely to be from the propranolol
what side effects
are more likely to be from the Topamax
because you can have overlapping side effects okay
the propranolol can make some people feel kind of foggy
like the Topamax right
but again
because I have gotten to know my clients so well
I can say okay
for you I know you really want to come off this Topamax
right like I get it
but let's start with the lowest hanging fruit
let's start with the one
where we have the highest likelihood of success
and you could probably win down the quickest right
and we like get that off right
we we get get an easy win get a quick win right
I might give that advice to my client and say okay
when you go into your neurologist
have this conversation right
so again I'm not changing the prescription
but I'm educating my client
on how to have that conversation with the neurologist
and then also
I'm educating them on what is a reasonable wean off
approach to each particular medication
so they're not put in the typical position of oh
you've been on this medication for five years
and we're just gonna have you wean
off of it in two weeks and it's like
we're just gonna pull the rug out from under your body
right so I'm guiding them you know
I think that this would be a reasonable ween
off schedule it's probably going to take you
you know two months to come off of this Topamax
and so then they can go into the neurologist
instead of just sort of like okay
whatever they tell me I guess that's gonna be right
they're coming in educated
they can have the conversation
they know what questions to ask
etcetera and then also
they're going in and requesting a wean off to like
the right medication at the right time for them right
in other cases right they may be on
you know
propranolol and an antidepressant and the Topamax
and it's very clear
that the Topamax is really doping them up right
they've they're on the dopamax instead of the Topamax
right and so even though
you know another client
yeah let
why don't we start with the propanolo
like I think you'll be able to ween off of that
pretty quickly we get a quick win
then we move on to the stronger stuff
but for another client right
it's like every time I wash my hair
it's fistfuls of hair coming out and like I can't
you know think straight at work
I've just been like
hanging out for a year because I hope nobody notices
right it's like okay
this one really really severe side effects
we've gotten your body you know
restored where you're only having a mild migraine
you know every four to six weeks
let's tackle the topamax first
go into your neurologist
this is what I would think would be a reasonable ween
off schedule talk to your neurologist in this fashion
and you then my client goes in with that education
feeling empowered
feeling like they know how to have that conversation
and they know how to evaluate
what the neurologist is telling them right
so they're set up for success
so this is critical nobody has a Topamax deficiency
nobody was born with a necessity for Topamax
for their biochemistry no one on the planet
but what's happening to people is
they are being inappropriately taken
they're not weaning off their medication
at the right time
it's not an appropriate wean off schedule
they pull the rug out from under their body
and they have horrible experience
the number one thing that people say to themselves is
well I guess I needed that
and that is not the case nobody needs Topro Max
but you want to set yourself up for actual success
right so coming off of a preventative medication
your health has to be restored to a certain point
doesn't have to be 100% right
but we've got to get your health restored enough
so that the migraine
frequency and severity is noticeably diminished right
so then you can remove that preventative medication
you're not going to have a big
like explosion of migraines
that's the last thing that anybody wants
and so it's the right timing
and then the correct wean off approach
so those are the two most critical factors
for coming off of preventative medication
and these are things that
when people go into the neurologist
the neurologist is not taking into any consideration
they're unfortunately again
I'm not trying to be critical here
neurologist again
they are not trained to take people off medication
they're trained to put people on medication
so it's not their expertise
but they're not setting people up for
and again
by the time we're on those preventive medications
we already feel like we're doomed and defective
our body hates us something wrong with our genes right
we're already struggling under that horrible
mental weight of having these chronic migraines
and then somebody tries to
come off of a medication is not successful
and then it just is like oh
I guess I needed that I guess I really am defective
I guess there really is something wrong with me
that I've got to have this medication
for the rest of my life
all of this is avoidable
so if this has been your experience
okay reach out
this is something that I can help you with
I have walked hundreds of clients through this process
over the years
so please reach out to me and schedule a consult
call with me
I would love to talk with you about what's going on
with your migraines right now
what's going on with your prescription medication
right now
and what your goals are around your medication
coming off any medication that you have
if you've tried in the past and been unsuccessful
it's not your fault okay
it's not your fault in the least
it's not the fault of your genetics
it's not you know
your body doesn't hate you
I had a client this takes the cake
her neurologist
told her that her brain had faulty wiring
and that's why she had the migraines
I mean a neurologist said this okay
none of this is the case
so if you've been unsuccessful in the past
it's just because you haven't been set up for success
so let's set you up for success
so that you can feel better than you have in years
literally years
and I can help you work with your prescribing doctor
and come off of these medications
that are not getting to the root cause
and are making you feel worse
definitely in the long term
and even on a day to day basis
if you're struggling with side effects
so I hope this helps let me know in the comments
what experience you've had with your neurologist
or your primary care doctor
trying to come off medications
I'd love to hear from you in the comments
so great
thanks for joining me today and I will talk to you soon