title: Perimenstrual migraines and their response to preventive therapy with topiramate.
abstract: BACKGROUND
  Preventive treatment with topiramate is effective for overall reduction of migraine frequency, but there are few data regarding its efficacy on perimenstrual migraines. To determine whether topiramate can prevent perimenstrual migraines, we analyzed data from premenopausal women as a subgroup of the Prolonged Migraine Prevention with Topiramate (PROMPT) study.
  
  
  METHODS
  In total, 198 women from the PROMPT study with menstrually related migraine (MRM) were evaluated. After a one-to-two-month prospective baseline period, patients received open-label topiramate (50-200 mg/day) for six months.
  
  
  RESULTS
  During topiramate treatment, mean monthly migraine frequency was reduced from 7.03 at baseline to 4.36 (mean change: -2.66; p < .001, endpoint analysis). Mean percentage reductions were similar for migraines during and outside the perimenstrual period (-45.9% and -46.1%, respectively). In patients with aura, reductions in migraine days with (-48.3%) or without (-43.4%) aura were similar to those in patients without aura (-45.4%). Reductions were also similar whether women were taking combined oral contraceptives (-47.0%) or were not (-46.6%).
  
  
  CONCLUSIONS
  Topiramate reduces the frequency, but not severity or duration, of perimenstrual migraines in women with MRM, including migraines with and without aura, and regardless of combined oral contraceptive use.
authors.affiliation: Women's Headache Center, Department of Gynecology and Obstetrics, University of Turin, Italy. gb.allais@tiscali.it
authors.forename: Gianni
authors.initials: G
authors.lastname: Allais
authors.forename: Margarita
authors.initials: M
authors.lastname: Sanchez del Rio
authors.forename: Hans-Christoph
authors.initials: HC
authors.lastname: Diener
authors.forename: Chiara
authors.initials: C
authors.lastname: Benedetto
authors.forename: Joop
authors.initials: J
authors.lastname: Pfeil
authors.forename: Barbara
authors.initials: B
authors.lastname: Schäuble
authors.forename: Joop
authors.initials: J
authors.lastname: van Oene
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage*; D003277:Contraceptives, Oral, Combined / Q000008:administration & dosage; D005260:Female; D005632:Fructose / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D008599:Menstruation Disturbances / Q000188:drug therapy / Q000517:prevention & control*; D008875:Middle Aged; D020325:Migraine with Aura / Q000188:drug therapy / Q000517:prevention & control*; D020326:Migraine without Aura / Q000188:drug therapy / Q000517:prevention & control*; D011446:Prospective Studies; D012720:Severity of Illness Index; D000077236:Topiramate; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D003277:Contraceptives, Oral, Combined; D000077236:Topiramate; D005632:Fructose