I total understand what you are facing. I'm 28 and never had headaches until about 1.5yrs ago. I though I was going crazy. I tried all the OTC drugs then went to my PCP for help. After several meds and 2 doctors I decided I had a real problem. I started looking for someone who specialized in headaches. I am lucky to live in Houston and have some great resources at hand. I ended up with a top specialist who let me know what I was feeling was a chronic daily migraine. He let me know it may never go away or may come and go in and out of remission. I have been on topomax with the same problems you are having. It would work and then fade. I ended up at 800mg...but the side effects were too bad to keep it up. I had to take a medical leave from work to go cold turkey off the topomax. Once "clean" I started on Depakote. For me it has been awesome. It keeps me feeling like normal about 3 weeks a month. The only side effects it leaves behind are problems with speech and some weight gain. One thing I can tell you is my Doc always gives me hope. He tells me that this is not easy to treat but there are always new drugs that can help. I am going to try Cymbalta (sp?) next. There are even implants that help some and injections that help others. The only regret I have is deciding to wait to have children. I never considered that my health would be an issue. I'm not sure I can stand to get off these meds to have a baby. I am considering adopting but would like to experience being pregnant. For now I try to stay focused on the positive and say a "thank you" everyday for some relief.