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Topiramate may help prevent migraines

24 September, 2002

The anti-epileptic drug topiramate may help to prevent migraine headaches, according to research presented at the American Medical Association's Science Reporters Conference in Washington DC.

Dr Stephen D. Silberstein, professor of neurology and director of the Jefferson Headache Center at Thomas Jefferson University in Philadelphia. Dr. Silberstein revealed that topiramate at 100 mg to 200 mg a day produced "a significant decrease in the frequency of migraine attacks, and the number of days people experienced migraines".

The variations in migraine symptoms and medication overuse by migraineurs (people who are prone to migraines) often contribute to making migraine headaches a difficult disorder to treat. The types of symptoms migraineurs experience often predict what type of medication will work for them, and early intervention often helps to eliminate or lessen debilitating symptoms. Patients who have chronic daily headaches, however, often have difficulty finding relief from their pain. Dr Silberstein stated:

"Some typical problems include tolerance to medication, withdrawal (including headache) if they stop taking medication and side-effects from drug toxicity.The constant pain leads many to overuse medication."

The advent of topiramate as migraine therapy may help people with chronic migraine distress. According to Dr Silberstein, the drug is an effective preventive agent. Although over 50 per cent of patients experienced a 50 per cent decrease in their migraine periods, a few had side-effects, including nausea, depression, fatigue and nervousness, among others. Most patients, however, did not experience side-effects, and the benefits in the severity of symptoms and frequency of attacks were significant. An interesting side-effect was weight loss. Dr Silberstein concluded:

"The problem in treating migraine is we don’t know who will respond to what treatment, and a given treatment can take four to six weeks to take effect."

The most important points in treating acute migraines is to treat it as early as possible, try alternatives to drugs such as rest, avoid uncomfortable stimuli (such as noise and light), and use cold compresses, Dr Silberstein stated. Medication is usually necessary and the type and dose taken should match the severity of the attack.