On 50mg pamelor migrane + 50mg topamax (topiramate) qhs, neuro wants me to take 25mg topamax (topiramate) in am too but makes me sleepy, can i take all 75 topamax (topiramate) + pamelor qhs?

MY OPINION: In some cases, the topamax (topiramate) will be more effective if used once every 12 hrs, but the drowsiness adverse effect may not go away. Although the Pamelor is a rather poor preventative, and not fda approved, this could be used once daily at higher dosage perhaps. But how about an otc approach using butterbur, feverfew, or riboflavin, or co-q10? Likely fewer side effects, if any.

Pamelor/Topamax: At that dose & if ok with your doctor, should be fine.