title: Effective dose of topiramate in pediatric migraine prophylaxis.
abstract: OBJECTIVE
  Migraine is a common neurological disorder in childhood and adolescence. Topiramate is a new anticonvulsant drug, recently being used in migraine prophylaxis in adults, although it is not approved by the Food and Drug Administration for prevention of pediatric migraine. The present study was planned and performed to evaluate the efficacy of low-dose topiramate in pediatric migraine prophylaxis.
  
  
  METHODS
  A prospective study, including 60 patients with migraine headaches was performed for a period of two months. The patients were randomly divided into two treatment groups - treated by topiramate < 2 mg/kg/day and > 2 mg/kg/day. All the patients were evaluated at 0, 4, and 8 weeks of the study for the clinical response.
  
  
  RESULTS
  The patients receiving topiramate < 2 mg/kg/day (mean dose of 1.2 ± 0.7 mg/kg/day) showed a reduction in the mean (±SD) of migraine frequency from 6.2 (±2.4) to 3.0 (±1.8) episodes per month, headache intensity from 7.2 (±1.95) to 3.7 (±1.8) based on the Visual Analog Scale, and headache duration from 5.4 (±2.1) to 2.2 (±1.3) h. In the patients treated with topiramate > 2 mg/kg/day (mean dose of 2.4 ± 0.5 mg/kg/day), the mean (±SD) of monthly headache frequency reduced from 6.9 (±2.1) to 3.24 (±1.2) per month, intensity from 7.11 (±1.4) to 3.14 (±2.41), and headache duration from 5.2 (±2.4) to 1.8 (±1.2) h, at the end of follow-up (P > 0.05). The most common side effects of topiramate were paresthesias (five patients), anorexia (four patients), drowsiness (four patients).
  
  
  CONCLUSIONS
  The results of this study demonstrated that low-dose of topiramate (<2 mg/kg/day) is effective, well-tolerated, safe, and suggested as an alternative prophylactic treatment for pediatric migraine.
authors.affiliation: Department of Pediatrics, Booali Sina Hospital, Sari, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Abbaskhanian
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Sadeghi
authors.forename: Ali
authors.initials: A
authors.lastname: Erfani
authors.forename: Mohammad Sadegh
authors.initials: MS
authors.lastname: Rezai
keywords: Pediatric migraine; prophylaxis; topiramate
references.citation: Pediatr Neurol. 2009 Sep;41(3):167-70
references.pmid: 19664530
references.citation: Acta Paediatr Suppl. 1962 May;136:1-151
references.pmid: 13869189
references.citation: J Pediatr Health Care. 2007 Nov-Dec;21(6):392-5; quiz 396-8
references.pmid: 17980806
references.citation: Arch Neurol. 2004 Apr;61(4):490-5
references.pmid: 15096395
references.citation: Neuroscientist. 2005 Aug;11(4):373-86
references.pmid: 16061523
references.citation: J Am Osteopath Assoc. 2005 Apr;105(4  Suppl 2):2S-8S
references.pmid: 15928347
references.citation: Neurology. 1993 Oct;43(10):1954-60
references.pmid: 8413952
references.citation: Pediatrics. 2009 Mar;123(3):924-34
references.pmid: 19255022
references.citation: Clin Evid. 2006 Jun;(15):469-75
references.pmid: 16973019
references.citation: J Cent Nerv Syst Dis. 2011 Jun 23;3:155-68
references.pmid: 23861645
references.citation: Epilepsia. 1997;38 Suppl 1:S24-7
references.pmid: 9092954
references.citation: Headache. 2006 Nov-Dec;46(10):1503-10
references.pmid: 17115983
references.citation: Pediatr Neurol. 2005 Nov;33(5):314-6
references.pmid: 16243217
references.citation: Headache. 1976 Jan;15(4):288-90
references.pmid: 1245411
references.citation: Curr Treat Options Neurol. 2004 Nov;6(6):471-487
references.pmid: 15461925
references.citation: Headache. 2002 Sep;42(8):804-9
references.pmid: 12390645
references.citation: Dev Med Child Neurol. 1992 Dec;34(12):1095-101
references.pmid: 1451940
references.citation: J Child Neurol. 2005 Mar;20(3):251-3
references.pmid: 15832623
references.citation: J Child Neurol. 2005 Aug;20(8):667-9
references.pmid: 16225812
references.citation: Expert Opin Pharmacother. 2002 Oct;3(10):1433-42
references.pmid: 12387689
references.citation: Neurology. 2004 Apr 27;62(8):1261-73
references.pmid: 15111660
references.citation: Rev Neurol (Paris). 2005 Jul;161(6-7):689-91
references.pmid: 16141961
references.citation: Headache. 2004 Mar;44(3):230-7
references.pmid: 15012660