title: Open-label zonisamide for refractory migraine.
abstract: 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.
authors.affiliation: Ohio State University, Columbus, Ohio 43210, USA. medrake1@pol.net
authors.forename: Miles E
authors.initials: ME
authors.lastname: Drake
authors.forename: Nancy I
authors.initials: NI
authors.lastname: Greathouse
authors.forename: Janet B
authors.initials: JB
authors.lastname: Renner
authors.forename: Arito D
authors.initials: AD
authors.lastname: Armentbright
mesh_terms: 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
chemical_list: D000927:Anticonvulsants; D007555:Isoxazoles; D000078305:Zonisamide