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Topiramate: A Case Series Study in Migraine Prophylaxis
WB Young, MM Hopkins, AL Shechter & SD Silberstein
Posted: January 2003  
Cephalalgia 2002; 22:659-663

We received the electronic records of 74 migraine patients treated with topiramate for more than 6 weeks. Twenty-four patients had episodic migraine and 50 had chronic (transformed) migraine. Most (81%) started treatment at 25 mg. per day and reached a dose of 100 mg. twice a day. The mean headache frequency decreased from 20.6 days to 13.6 days per month for all headaches, and 25.7-17.7 for episodic migraine and chronic migraine, respectively. The percentage of patients whose headache frequency was reduced by more than 50% was 44.6% for all patients; 58.3 for episodic migraine and 38.0 for chronic migraine. For all patients mean headache severity (10-point scale) was reduced from 6.2 to 4.8. Patients on monotherapy (20%) and polytherapy (80%) had similar reductions in headache frequency. Adverse events were usually mild to moderate and were seen in 58.1% (paresthesias in 25%, cognitive difficulties 14.9%. Mean weight loss was 3.1 kg.