Il Topiramato nella terapia di profilssi delle micrania: Uno studio pilota

Topiramate is an antiepileptic drug of new generation that modulates voltage-dependent sodium conductance, potentiates gamma-aminobutyric acid-evoked currents, and blocks the kainate/AMP A (alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid) subtype of the glutamate receptor. We report the results of a three-month open study on the effects of topiramate in the prophylaxis of patients with migraine meeting the IHS criteria. We treated 20 patients suffering from migraine with or without aura. Patients treated their attack at home using symptomatic drugs and clinical assessment was recorded on a diary. After a washout of 8 week from any other prophylactic treatment, all patients were treated with 100 mg/day of topiramate; this is our therapeutic plan: 50 mg/day from 1(st) to 7(th) day and 100 mg/day from 8(th) day. No patients withdrew, topiramate was well tolerated; adverse events (vertigo, ataxia, paraesthesia, speech disorders) generally were transient and mild to moderate in severity. At the end of treatment, in such case, we reported a significative reduction of frequency and intensity of migraine in all patients treated with topiramate. Our observations indicate that topiramate is well tolerated by patients and that reduces headache frequency and use of symptomatic drugs in both groups.