Open-label zonisamide for refractory migraine.
OBJECTIVE
Zonisamide is a novel anticonvulsant drug with multiple mechanisms of action, many of which may confer efficacy in the treatment of migraine headaches. This study investigated the use of open-label zonisamide in treating patients with refractory migraine headaches.


METHODS
Thirty-four migraine patients were initiated on a 100-mg/day zonisamide dosage, which was titrated to 400 mg/day as tolerated. Mean headache severity, frequency, and duration were assessed before and 1, 2, and 3 months after initiation of zonisamide therapy.


RESULTS
Statistically significant improvements in headache severity (P <0.01), duration (P <0.05), and frequency (P <0.05) were evident after 1 month of zonisamide therapy and were carried through month 3 of treatment. Zonisamide was well tolerated, with only 4 patients (11.8%) discontinuing for adverse events, including dysphoria (n=2) and difficulty concentrating (n=2). Other adverse events were transient and tolerable.


CONCLUSIONS
: These results suggest that zonisamide may be a safe and effective adjunctive agent for migraine prevention. Double-blind studies are warranted to confirm these findings.
Drake
Miles E
ME
Ohio State University, Columbus, Ohio 43210, USA. medrake1@pol.net
Greathouse
Nancy I
NI
Renner
Janet B
JB
Armentbright
Arito D
AD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007555:Isoxazoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome; D000078305:Zonisamide
D000927:Anticonvulsants; D007555:Isoxazoles; D000078305:Zonisamide