Epilepsy Drug Fights Migraine

Topamax Prevents Chronic Migraines

From the WebMD Archives

Sept. 23, 2002 -- Migraine headaches are among the oldest known health complaints, but doctors are still learning new tricks to help people cope and even prevent the painful attacks. In fact, a new study suggests many migraine sufferers may find relief in a drug traditionally used to treat epilepsy.

By using about half the normal dose prescribed for epilepsy, researchers found treatment with the drug Topamax cut the number of migraine episodes in half for more than 50% of the migraine sufferers.

About 500 people with chronic migraine were in the study -- presented last week at a meeting sponsored by the American Medical Association in Washington, D.C.

Using a 100 mg dose, the study found 54% of the patients enrolled experienced a 50% or more reduction in the number of migraine episodes, vs. 23% who reported similar effects on the placebo. In addition, those treated with Topamax also reported a reduction in the frequency of migraine attacks, their duration, and the average number of migraine days.

Some drugs used to prevent migraines have the unwanted side effect of prompting weight gain. But researchers say Topamax also had the added benefit of inducing weight loss rather than weight gain.

"This is first medication we have that actually produced nearly 4% weight loss on average," says study researcher Stephen Silberstein, MD, director of the Jefferson Headache Center at Thomas Jefferson University in Philadelphia.

Silberstein says there are two types of treatment for migraine: acute and preventative. Acute therapies involve taking a medication after the migraine starts to alleviate the pain and other symptoms. Preventive therapies use daily medications to reduce the frequency, duration, and severity of migraine attacks.

Triptans, a class of drugs that include Imitrex and Zomig, are commonly used to treat the migraines after they occur and work by blocking the pain receptors in the nerve endings in the nervous system.

In contrast, Silberstein says preventive drugs, such as Topamax, work in a different way to dampen down the entire pain relay system.

He says unlike epilepsy patients who must take the medication for the duration of their illness, some migraine patients may get long-term relief from short-term use of Topamax. Research shows the drug can effectively turn off the migraine process in some patients after about 3-6 months of use.

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