[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.
Pascual-Gómez
Julio
J
Servicios de Neurología, Hospital Universitario Marques de Valdecilla, Santander, Espana. juliopascual@telefonica.net
Gracia-Naya
Manuel
M
Leira
Rogelio
R
Mateos
Valentín
V
Alvaro-González
Luis Carlos
LC
Hernando
Ignacio
I
Oterino
Agustín
A
Iglesias--Díez
Fernando
F
Caminero
Ana
A
García-Moncó
Juan Carlos
JC
Forcea
Nerea
N
Guerrero-Peral
Angel Luis
AL
Bueno
Valentín
V
Santos-García
Diego
D
Pérez
Celia
C
Blanco
Miguel
M
Pego-Reigosa
Robustiano
R
Rodríguez
Rosa
R
Mederer-Hengstl
Susana
S
Pato-Pato
Antonio
A
Sánchez-Herrero
Joaquín
J
Maciñeiras-Montero
José Luis
JL
Ortega
Fernando
F
Arias
Mónica
M
Díaz-González
Manuel
M
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