[Zonisamide in the preventive treatment of refractory migraine].
BACKGROUND
Chronic migraine refractory to preventive treatment is a common clinical situation in general neurology clinics. The aim is to analyse our experience with zonisamide in the preventive treatment of patients with frequent refractory migraine.


METHODS
Those patients with no response or intolerance to topiramate and at least one more preventative received zonisamide. This drug was increased 25 mg per week up to 200 mg/day. The efficacy of zonisamide 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 172 patients, with ages ranging from 22 to 69 years. 85% were women. The final dosage of zonisamide was 50-200 mg/day, with the 100 mg/day being the most frequently administered dose. Zonisamide was efficacious (response) in 76 (44%) patients; response being excellent in 22 (13%). MIDAS score was reduced by 43.2%. Zonisamide was not tolerated by 27% of the patients, mainly due to subjective mental slowness or digestive symptoms.


CONCLUSIONS
These results, obtained in a big sample of patients refractory or intolerant to topiramate and other preventatives, indicate that, at least in conditions of daily clinical practice, zonisamide, at relatively low dosages, is an option to be considered for the preventive treatment of patients with frequent migraine.
Servicios de Neurología, Hospital Universitario Marques de Valdecilla, Santander, Espana. juliopascual@telefonica.net
Julio
J
Pascual-Gómez
Manuel
M
Gracia-Naya
Rogelio
R
Leira
Valentín
V
Mateos
Luis Carlos
LC
Alvaro-González
Ignacio
I
Hernando
Agustín
A
Oterino
Fernando
F
Iglesias--Díez
Ana
A
Caminero
Juan Carlos
JC
García-Moncó
Nerea
N
Forcea
Angel Luis
AL
Guerrero-Peral
Valentín
V
Bueno
Diego
D
Santos-García
Celia
C
Pérez
Miguel
M
Blanco
Robustiano
R
Pego-Reigosa
Rosa
R
Rodríguez
Susana
S
Mederer-Hengstl
Antonio
A
Pato-Pato
Joaquín
J
Sánchez-Herrero
José Luis
JL
Maciñeiras-Montero
Fernando
F
Ortega
Mónica
M
Arias
Manuel
M
Díaz-González
D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007555:Isoxazoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy / Q000517:prevention & control; D017060:Patient Satisfaction; D016896:Treatment Outcome; D055815:Young Adult; D000078305:Zonisamide
D000927:Anticonvulsants; D007555:Isoxazoles; D000078305:Zonisamide