I believe that your body adjusts.....or at least mine did. I only take ibuprofen when the pain is bad and I have Meloxicam for when it is really bad. I am learning to tolerate and am thankful that my condition is not as advanced as many others on here. I have allergic reactions to all the pain meds I have tried. The only thing with the meloxicam is I feel medicine heady the whole next day. Have not tried Topomax, but wish you all the best. A towel warmed in the microwave or a warm bath works wonders. Hope this helps you and good luck. I would not choose the brain fog...I have teens and they might run amock if I wasn't "all there." Ha! They may think that anyway. Tee Hee!