title: [Comparative study of the effectiveness of topiramate and nadolol in the preventive treatment of episodic migraine in independent series of patients].
abstract: BACKGROUND
  Topiramate and nadolol with levels A and C of scientific evidence, respectively, would be indicated as preventive treatments of migraine. To date only one study of satisfaction has been carried out to compare the two pharmaceuticals.
  
  
  OBJECTIVE
  To compare the effectiveness parameters in independent groups of patients treated preventively with one of the pharmaceuticals from the study.
  
  
  METHODS
  From a database of 700 patients with migraine, those with episodic migraine and who had followed a course of preventive treatment, for the first time, with topiramate or nadolol were selected for the study. The effectiveness variables (reduction in the number of crises at four months of preventive treatment and responder rates) were analysed.
  
  
  RESULTS
  Altogether 208 patients with were included for treatment: 140 with topiramate (77.8% females; mean age, 37.9) and 68 with nadolol (69% females; mean age, 36.9). The mean number of crises in the month prior to treatment was: topiramate group, 6.3 +/- 2.6; nadolol group 5.3 +/- 2.0 (p = 0.0066). At four months after starting treatment: topiramate group, 2.69 +/- 2.6; nadolol group 2.6 +/- 2.2 (NS). The percentage of reduction in the number of migraines was 56.6% with topiramate and 51.6% with nadolol (NS). The responder rate (reduction in the frequency of crises by at least 50%) was 71.3% with topiramate versus 69% with nadolol (NS). The excellent response rate (reduction in crises by at least 75%) was 53.3% with topiramate versus 32.2% with nadolol (p = 0.0077). Adverse side effects were reported by 54% of patients treated with topiramate versus 30.8% of those treated with nadolol (p = 0.0015). The rate of satisfaction was 61% for the topiramate group and 71% for the group with nadolol (NS).
  
  
  CONCLUSIONS
  Both topiramate and nadolol proved to be effective in the preventive treatment of episodic migraine. Topiramate was found to be more effective than nadolol, although it was used in patients with a higher frequency of crises, and was not tolerated so well.
authors.affiliation: Servicio de Neurología, Hospital Universitario Miguel Servet, Zaragoza, España. gracia.naya@meditex.es
authors.forename: Manuel
authors.initials: M
authors.lastname: Gracia-Naya
authors.forename: Mariano
authors.initials: M
authors.lastname: Huerta-Villanueva
authors.forename: Consuelo
authors.initials: C
authors.lastname: Ríos-Gómez
authors.forename: Ana M
authors.initials: AM
authors.lastname: Latorre-Jiménez
authors.forename: Sara
authors.initials: S
authors.lastname: Sánchez-Valiente
authors.forename: Sonia
authors.initials: S
authors.lastname: Santos-Lasaosa
authors.forename: José Angel
authors.initials: JA
authors.lastname: Mauri-Llerda
authors.forename: M José
authors.initials: MJ
authors.lastname: García-Gómara
authors.forename: Jorge
authors.initials: J
authors.lastname: Artal-Roy
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000517:prevention & control*; D009248:Nadolol / Q000627:therapeutic use*; D000077236:Topiramate
chemical_list: D000319:Adrenergic beta-Antagonists; D000077236:Topiramate; D005632:Fructose; D009248:Nadolol