Migraine Prevention? Scientists Teach an Old Drug a New Trick
By Ed Susman
WebMD Medical News
May 8, 2000 (San Diego) -- There is new hope for people who suffer from migraine headaches -- especially those who have frequent, disabling attacks. Two drugs used to treat seizure disorders like epilepsy have been found to reduce the frequency of migraine attacks, according to research presented here at a meeting of the American Academy of Neurology.
"These are quite important studies," Peter Goadsby, MD, PhD, of the National Hospital for Neurology and Neurosurgery in London, tells WebMD. Goadsby was not involved in the studies but served as a co-moderator of a panel that discussed the latest advances in migraine treatments. "[They] are important from the clinical point of view, especially for patients who have a lot of headaches," he says. "It would make more sense to take a drug to prevent migraine if the attacks occurred frequently."
One drug -- the extended-release form of Depakote -- is currently approved by the FDA to control seizures and various other conditions. In the study, which involved more than 200 migraine sufferers, people who took this drug were compared to a group who took a dummy pill, or placebo. The Depakote group reported a significant reduction in their migraine headaches, says Frederick Freitag, DO, associate director of the Diamond Headache Center in Chicago. In addition, the patients taking Depakote suffered from headaches for fewer days over the course of the four-week study than did the patients who took the placebo.
Patients in the study had suffered migraines for an average of 20 years. These people, Freitag says, represent "a typical group of migraine sufferers." Most of them were women -- about 80%. That is similar to national statistics. Of the 28 million Americans who suffer the throbbing pain, the nausea, and the extreme sensitivity to motion, sound, and light that come with migraines, women outnumber men by 3 to 1.
"Several studies have shown that [Depakote] reduces migraine attacks," Stephen Silberstein, MD, tells WebMD. "This study shows that the new extended-release form works as well as other dosages." Silberstein, another co-moderator of the panel discussion, was not involved in the study. He is professor of neurology and director of the Jefferson Headache Center at Thomas Jefferson University in Philadelphia.
In a second report, James Storey, MD, a researcher with Upstate Neurology Consultants in Albany, N.Y., said the anticonvulsant Topamax was better than placebo pills at reducing the monthly occurrence of headaches. The 19 patients on Topamax and 20 on a placebo had all suffered from migraines for at least a year before entering Storey's study. They were enrolled in the study only if they were actively having frequent migraines. The side effects of the drug were generally mild, Storey says.
"Some doctors are already using these drugs to prevent migraine headaches in patients," notes Silberstein. He says this new research showed that both Depakote and Topamax are effective in preventing migraines in patients at high risk for frequent attacks. They should become part of physicians' standard tools for treating the condition, he says.