I saw my PCP yesterday...I was supposed to wait a month to see him, but moved it up by 9 days because I was miserable. I asked him if we could change some meds, because it just seems like the ones I'm on are not working. I'm getting at least a dozen migraines per month, and the FM pain is getting out of hand. I'm currently taking Topamax (50 mg/morning and 100 mg/night), Flexeril (10 mg/night), Cymbalta 60 mg., Ultram, Vicodin prn for headaches, and Zomig prn for migraines. Topamax, Cymbalta and Zomig are not on my insurance formulary. That means my copay for each is $55/month. Considering that my husband is currently out of work, that is a lot of money (heck, it's a lot of money even when he's working!). When it seems like Topamax and Cymbalta aren't doing anything but lowering my bank balance, it's galling to say the least. (Topamax seemed to work at first, but the last several months the migraines have come back with a vengeance. My neurologist upped my dosage from 100 mg/day to 150 mg/day, but it hasn't helped.) At my last appt. I told my doc that the Vicodin was making me itch. He said to take the Ultram instead. Well, the Ultram just doesn't do it for those major headaches - it doesn't even do it for the FM pain! So I kept taking the Vicodin and just took Benadryl for the itching. The trouble is, I am getting low on Vicodin and the doc doesn't want to give me more. (He is concerned that I am getting dependent on it because I have been taking it so long and need a higher dose to get pain relief.) He also believes that opioids do not work for FM pain "unless you take so much that you get loopy and you just don't care." He thinks the reason I am so symptomatic right now is because I am so stressed out and depressed. I am unwilling to say he's wrong - the money situation is really getting to me. My husband can't even collect unemployment, so my income is all we have to live on until he finds another job. (With two little kids and a ton of debt, that is a lot of pressure!) The doc decided to take me off the Cymbalta and put me on Zoloft and Elavil. We will also change the Flexeril to "as needed." We will meet again in 2 weeks to see if further changes are needed. He wants to make changes slowly, though, so we will know what changes are helping or not helping. We will also talk about the possibility of changing from Topamax to Neurontin at that time. My husband wonders - TWO anti-depressants? Is that OK? I wondered what you all thought about that. Has anyone here done a tricyclic (such as Elavil) at the same time as an SSRI (such as Zoloft)? I would also welcome your thoughts on other meds/issues I've brought up. Please share your wisdom with me! And thanks for slogging through my very long post.