Efficacy of Topiramate in Migraine Prophylaxis: A Retrospective Chart Analysis

Seggern, Randal L. Von; Mannix, Lisa K.; Adelman, James U.

doi:10.1046/j.1526-4610.2002.02184.x

Cited by 45 publications

(43 citation statements)

References 20 publications

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“…Several other studies have demonstrated topriamate's efficacy in migraine treatment (77,78). These results show that topiramate is effective for migraine prevention.…”

supporting

confidence: 57%

Botulinum Toxin and Other New Approaches to Migraine Therapy

Ashkenazi

Silberstein

2004

Annu. Rev. Med.

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The number of migraine treatments and our understanding of migraine pathophysiology are both increasing. Newer treatments focus on migraine prevention. Botulinum toxin (BTX) is a potent neurotoxin used primarily to treat diseases associated with increased muscle activity. Recently, BTX was found to have antinociceptive effects that are probably independent of its muscle-relaxant action. Clinical trials support the efficacy of BTX type A (and possibly also type B) in the treatment of migraine. The anticonvulsant topiramate was recently shown to be effective for migraine prevention. At the low doses used for this indication, cognitive side effects are not a major concern. Another new approach to migraine prevention is angiotensin type 1 (AT1) receptor blockade. The high tolerability of the AT1 receptor blocker candesartan warrants further studies to assess its role in migraine prevention.

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“…Several other studies have demonstrated topriamate's efficacy in migraine treatment (77,78). These results show that topiramate is effective for migraine prevention.…”

supporting

confidence: 57%

Botulinum Toxin and Other New Approaches to Migraine Therapy

Ashkenazi

Silberstein

2004

Annu. Rev. Med.

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“…Many studies have confirmed a significant therapeutic effect at the low dose of 100-200 mg/day, with the added advantage of better tolerability and lower discontinuation rates. Lower doses of topiramate are effective in migraine prophylaxis [50][51][52][85][86][87][88][89] and cluster headaches [90,91], partial-onset seizures [41,42,[92][93][94] and idiopathic generalized epilepsy [90].…”

Section: Tolerabilitymentioning

confidence: 99%

“…Discontinuation rates ranging from 1.8-9.0% have been reported [41,42,[50][51][52]85,87,89,90,93,94]; most discontinuation occurs early in the phase of treatment and is associated with higher titration rates [40]. A randomized, controlled trial of topiramate at doses of 50, 100 and 200 mg/day versus placebo for migraine reported cognitive side effects (language problems or difficulty in concentration) in fewer than 10% of subjects in the 50 and 100 mg/day groups [50].…”

Section: Tolerabilitymentioning

confidence: 99%

Topiramate for the treatment of epilepsy and other nervous system disorders

Passel

Arif

Hirsch

2006

Expert Review of Neurotherapeutics

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Initially synthesized as an oral hypoglycemic agent, topiramate was approved for use as an anticonvulsant in 1996. Its broad spectrum efficacy in epilepsy, including as monotherapy and in children, is well established. Topiramate has also been used in the management of nonepileptic neurologic and psychiatric conditions, including migraine prophylaxis (with firmly established efficacy), obesity (with some evidence of long-term maintenance of weight loss), substance dependence, bipolar disorder and neuropathic pain, and it has been investigated as a possible neuroprotective agent. Paresthesias and cognitive side effects are the most common troublesome adverse effects. Recent trends towards lower doses may help achieve the best combination of efficacy and tolerability.

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“…Topiramate has demonstrated efficacy for the treatment of migraine in open-label (Hershey et al, 2002;Mathew et al, 2002;Von Seggern et al, 2002;Young et al, 2002), and double-blind trials (Storey et al, 2001;Brandes et al, 2003;Dodick et al, 2003;Rothrock et al, 2003), significantly decreasing the frequency and severity of migraine, and the need for abortive medications. In a doubleblind trial in 40 patients, topiramate significantly reduced migraine frequency compared with placebo (36% vs 14%) (Storey et al, 2001).…”

Section: Migraine and Pain Syndromesmentioning

confidence: 99%

Comorbidity in bipolar disorder: a framework for rational treatment selection

McIntyre

Konarski

Yatham

2004

Human Psychopharmacology

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Bipolar disorders are heterogeneous disorders often requiring multimodality treatment. The expanding pharmacopeia for bipolar disorders invites the need for a treatment framework that both recognizes and anticipates the multidimensionality and comorbidity of the illness. No available neurotherapeutic agent is singularly efficacious for the complete mélange of bipolar symptomatology. An apparent paradox has emerged in the management of bipolar disorder; whilst results from rigorous controlled monotherapy trials suggest that a disparate assortment of neurotherapeutic agents are efficacious in distinct phases of bipolar disorder, the majority of tertiary-treated bipolar patients receive polypharmacotherapeutic regimens. The evidentiary base for polypharmacotherapy is sparse and has recently become an area of active research focus. In the interim, clinicians are encouraged to invoke an organizational schema for the treatment of bipolar disorder that considers the spectrum of effectiveness of putative and established mood stabilizers. This schema should be further informed by the treatment data for comorbid and accessory conditions. The authors propose a schema to provide the impetus for further work in the area.

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Efficacy of Topiramate in Migraine Prophylaxis: A Retrospective Chart Analysis

Abstract: Topiramate may be effective in reducing the frequency of both mild and moderate/severe migraine headaches. In particular, topiramate may offer relief to patients with moderate/severe migraines who do not respond to other treatments.

Cited by 45 publications

References 20 publications

Botulinum Toxin and Other New Approaches to Migraine Therapy

Botulinum Toxin and Other New Approaches to Migraine Therapy

Topiramate for the treatment of epilepsy and other nervous system disorders

Comorbidity in bipolar disorder: a framework for rational treatment selection

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