title: Topiramate: a case series study in migraine prophylaxis.
abstract: We reviewed the electronic records of 74 migraine patients treated with topiramate for more than 6 weeks. Twenty-four patients had episodic migraine and 50 had chronic (transformed) migraine. Most (81%) started treatment at 25 mg per day and reached a dose of 100 mg twice a day (mean dose on the last follow-up visit was 208 mg). The mean headache frequency decreased from 20.6 days to 13.6 days per month (P<0.0001) for all headaches (9.9-5.1 (P<0.0001) and 25.7-17.7 (P<0.001) for episodic migraine and chronic migraine, respectively). The percentage of patients whose headache frequency was reduced by > or =50% was 44.6% for all patients; 58.3 for episodic migraine and 38.0 for chronic migraine. For all patients mean headache severity (10-point scale) was reduced from 6.2 to 4.8 (P<0.0001). Patients on monotherapy (20%) and polytherapy (80%) had similar reductions in headache frequency. Adverse events were usually mild to moderate and were seen in 58.1% (paresthesias in 25%, cognitive difficulties 14.9%). Mean weight loss was 3.1 +/- 4 kg (3.8% of total body weight).
authors.affiliation: Department of Neurology and Jefferson Headache Center, Thomas Jefferson University, Philadelphia, PA 19107, USA. William. B. Young@mail.tju.edu
authors.forename: W B
authors.initials: WB
authors.lastname: Young
authors.forename: M M
authors.initials: MM
authors.lastname: Hopkins
authors.forename: A L
authors.initials: AL
authors.lastname: Shechter
authors.forename: S D
authors.initials: SD
authors.lastname: Silberstein
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D004305:Dose-Response Relationship, Drug; D005260:Female; D005632:Fructose / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000517:prevention & control*; D018696:Neuroprotective Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011315:Preventive Medicine / Q000379:methods; D000077236:Topiramate; D016896:Treatment Outcome
chemical_list: D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose