Abstract:Migraine and migraine variants are common, chronic and incapacitating neurovascular disorders with a high impact on health resources. There is an extensive evidence base provided by double-blind, placebo-controlled trials showing that topiramate is a safe, effective and well tolerated drug in the management of migraine and its variants, being especially promising in the management of migraine-vertigo syndrome. Models both in the US and the UK have also shown that it offers a cost benefit when direct and indire… Show more
“…Topiramate is an antiepileptic drug that was first approved for the prevention of seizures in 1996 and received additional FDA approval for the prevention of migraines in adults in 2004 (FDA, ). The exact mechanism by which topiramate works to prevent migraine headache is not known, but seems to be related to alteration of biochemical processes and a reduction in neurologic hyperexcitability that can precede headache development in certain individuals (Carmona & Bruera, ; Janssen Pharmaceuticals, Inc., ; Rothrock, ). The medication is absorbed rapidly from the gastrointestinal tract regardless of timing with meals.…”
Section: Mechanism Of Actionmentioning
confidence: 99%
“…The medication is absorbed rapidly from the gastrointestinal tract regardless of timing with meals. Peak plasma concentrations can be reached within 2 hours of an oral dose (Carmona & Bruera, ; Janssen Pharmaceuticals, Inc., ). Because the burden of frequent migraines can be significant, preventing debilitating headaches before they begin is an important component of treatment…”
“…Topiramate is an antiepileptic drug that was first approved for the prevention of seizures in 1996 and received additional FDA approval for the prevention of migraines in adults in 2004 (FDA, ). The exact mechanism by which topiramate works to prevent migraine headache is not known, but seems to be related to alteration of biochemical processes and a reduction in neurologic hyperexcitability that can precede headache development in certain individuals (Carmona & Bruera, ; Janssen Pharmaceuticals, Inc., ; Rothrock, ). The medication is absorbed rapidly from the gastrointestinal tract regardless of timing with meals.…”
Section: Mechanism Of Actionmentioning
confidence: 99%
“…The medication is absorbed rapidly from the gastrointestinal tract regardless of timing with meals. Peak plasma concentrations can be reached within 2 hours of an oral dose (Carmona & Bruera, ; Janssen Pharmaceuticals, Inc., ). Because the burden of frequent migraines can be significant, preventing debilitating headaches before they begin is an important component of treatment…”
“…Migraine is a chronic neurologic disorder characterized by episodic attacks of severe headache accompanied by autonomic and neurologic symptoms, such as nausea, sensitivity to light and noise and, in some patients, an aura involving neurologic symptoms. 1 In the United States and Western Europe, the 1-year incidence of migraine is 11% among adults: 6% among men and 15 to 18% among women. 1 The disabilities associated with migraine can be severe.…”
Section: Introductionmentioning
confidence: 99%
“…1 In the United States and Western Europe, the 1-year incidence of migraine is 11% among adults: 6% among men and 15 to 18% among women. 1 The disabilities associated with migraine can be severe. Migraine imposes considerable burdens on the patient and on society, as well.…”
We conducted a prospective study to evaluate nasal signs and symptoms and to perform allergen-specific immunoglobulin E (IgE) testing to investigate the relationship between migraine and allergic rhinitis. Our study group consisted of 40 patients diagnosed with migraine-22 men and 18 women, aged 21 to 38 years (mean: 25.7). We compared their findings with a control group of 40 healthy adults-15 men and 25 women, aged 19 to 36 years (mean: 25.1). Allergen-specific IgE measurements were obtained with six groups of allergens: fungi, grass pollens, tree pollens, wild herbs, house dust mite 1, and house dust mite 2. We found no significant difference between the migraine patients and the controls in the incidence of nasal signs and symptoms (i.e., discharge, congestion, itching, and sneezing) or inferior turbinate signs (i.e., color and edema). According to the IgE assays, 14 migraine patients (35.0%) were sensitized to one or more allergens, compared with 11 of the controls (27.5%); the difference was not statistically significant. Sensitization was highest for the grass pollens panel in both groups. Even though we did not find an association between migraine and allergic rhinitis, the recent literature supports a correlation between migraine and atopy. The two conditions share common neural pathways and common mediators, and they can be linked statistically in patients and their families. A pathophysiologic association between the two conditions seems more likely than an etiologic association. In this regard, future efforts could be focused on the determination of atopy in migraine patients and the therapeutic implications of this diagnosis.
“…Absence from school and work or at least reduction of functional ability is common in migraineurs and leads to decreased social and economical productivity. 2 Therefore, a successful and easy-to-tolerate prophylactic treatment can increase the quality of life and reduce the need for acute medication and its relevant costs by decreasing the frequency and severity of migraine attacks and increasing the probability of response to symptomatic therapy. 3,4 Selection of a prophylactic regimen is dependent on the type of headache, drug efficacy, adverse effects, and patient's tolerance.…”
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.
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