title: Zonisamide versus topiramate in migraine prophylaxis: a double-blind randomized clinical trial.
abstract: BACKGROUND
  Topiramate is an antiepileptic drug that has been approved for migraine prophylaxis. Despite appropriate efficacy for migraine prophylaxis, some patients cannot tolerate its adverse effects. The aim of this study was to compare the efficacy of zonisamide, another antiepileptic drug, with topiramate in decreasing the frequency and severity of migraine attacks to determine whether it could be used as an alternative for noncompliant patients to topiramate.
  
  
  METHODS
  Eighty patients, recruited from referred migraineurs to our neurology clinic, who met the diagnosis and inclusion criteria were allocated randomly to group A (50-mg/d zonisamide, gradually titrated up to 200 mg/d) and group B (25-mg/d topiramate, gradually titrated up to 100 mg/d). Each patient was followed for 12 weeks and was assessed at entrance, in the fourth week and twelfth week for frequency of attacks, headache severity, need for acute medication, migraine disability assessment score, and adverse effects. A P < 0.05 was considered as the level of significant difference in all tests.
  
  
  RESULTS
  Both drugs caused a significant decrease in frequency, severity, need for acute medication in migraine attacks, and migraine disability assessment score (P < 0.05). Except headache severity that was reduced significantly better by zonisamide (P < 0.008), there were no significant difference between the 2 groups in other items. Except for 2 cases of intolerable paresthesia, both drugs were tolerated well during the study.
  
  
  CONCLUSIONS
  Our results indicated that zonisamide is as effective as topiramate in migraine prophylaxis and can be considered as an alternative treatment when topiramate is not tolerated well.
authors: Department of Neurology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors: Seyed Ehsan
authors: SE
authors: Mohammadianinejad
authors: Vahid
authors: V
authors: Abbasi
authors: Seyed Aidin
authors: SA
authors: Sajedi
authors: Nastaran
authors: N
authors: Majdinasab
authors: Fahimeh
authors: F
authors: Abdollahi
authors: Reza
authors: R
authors: Hajmanouchehri
authors: Asal
authors: A
authors: Faraji
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D018691:Excitatory Amino Acid Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005632:Fructose / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018755:GABA Agonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006261:Headache / Q000517:prevention & control; D006801:Humans; D007555:Isoxazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy* / Q000517:prevention & control / Q000534:rehabilitation; D010147:Pain Measurement; D010292:Paresthesia / Q000139:chemically induced; D010352:Patient Dropouts; D055502:Secondary Prevention; D012720:Severity of Illness Index; D026941:Sodium Channel Blockers / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D000077236:Topiramate; D000078305:Zonisamide
chemical_list: D000927:Anticonvulsants; D002121:Calcium Channel Blockers; D018691:Excitatory Amino Acid Antagonists; D018755:GABA Agonists; D007555:Isoxazoles; D026941:Sodium Channel Blockers; D000077236:Topiramate; D005632:Fructose; D000078305:Zonisamide