title: [Preventive treatment of chronic migraine with zonisamide: a study in patients who are refractory or intolerant to topiramate].
abstract: BACKGROUND
  About half of the patients with chronic migraine do not respond or do not tolerate the different migraine preventatives.
  
  
  OBJECTIVE
  To analyse the efficacy and tolerability of zonisamide in the treatment of migraine in patients who had not responded or tolerated topiramate, the current drug of choice for the treatment of this condition.
  
  
  METHODS
  Those patients with no response or intolerance to topiramate received zonisamide. This drug was increased 25 mg per week up to a maximum of 200 mg/day. The efficacy of this drug was evaluated in terms of 'response' (reduction in attack frequency below 50%) at the third month of treatment.
  
  
  RESULTS
  Our series comprises a total of 34 patients, most of them middle-aged women. All met chronic migraine criteria. Zonisamide showed efficacy (response) in 19 patients (56%), response being excellent in 6 (18%). Nine patients (26%) did not show response, whereas 6 (18%) did not tolerate the drug.
  
  
  CONCLUSIONS
  The results, obtained in patients refractory to other preventatives and particularly to topiramate, suggest that zonisamide can be useful in the prevention of chronic migraine. Of course, controlled clinical trials are necessary to confirm these preliminary results.
authors.affiliation: Servicio de Neurología, Hospital Universitario de Salamanca, Salamanca, España. juliopascual@telefonica.net
authors.forename: J
authors.initials: J
authors.lastname: Pascual-Gómez
authors.forename: M
authors.initials: M
authors.lastname: Alañá-García
authors.forename: A
authors.initials: A
authors.lastname: Oterino
authors.forename: R
authors.initials: R
authors.lastname: Leira
authors.forename: J M
authors.initials: JM
authors.lastname: Láinez-Andrés
mesh_terms: D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007555:Isoxazoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy / Q000517:prevention & control*; D000077236:Topiramate; D016896:Treatment Outcome; D055815:Young Adult; D000078305:Zonisamide
chemical_list: D000927:Anticonvulsants; D007555:Isoxazoles; D000077236:Topiramate; D005632:Fructose; D000078305:Zonisamide