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Efficacy of Topiramate in the Prophylactic Treatment
of Intractable Chronic Migraine
MC. Wilson
Posted: March 2005  
Cephalalgia Vol. 20, Number 4

Objective:   To perform a retrospective chart review of patients who had received topiramate for prophylaxis of intractable chronic migraine.

Methods:   Patient charts were reviewed and patients who had received topiramate for prophylaxis of intractable chronic migraine were analyzed for demographics, baseline characteristics, response to topiramate treatment, incidence of adverse events (AEs) and other variables.

Results:   Thirty-four patients, aged 24-65 years, meeting IHS criteria for chronic migraine were included in the analysis. The median duration of migraine in these patients was 20 years. Baseline headache rates ranged from 3-5 per week to daily or near-daily. At the time of analysis, 19 patients were improved or much improved and 15 patients reported no change with topiramate treatment. Topiramate was well tolerated. Fourteen patients reported no AEs. The most common AEs were fatigue, anorexia/weight loss and concentration difficulties. Seven patients discontinued due to AEs and 1 for lack of efficacy. Twelve patients reported weight loss.

Conclusions:   These encouraging results suggest topiramate is efficacious and well tolerated in this group of treatment-resistant patients for prophylaxis of intractable chronic migraine. Further study is warranted in larger, placebo-controlled, double-blind studies.