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Title: AHS: Anti-Epileptic Topamax (Topiramate) Appears Effective For Pediatric Migraine
URL: http://www.pslgroup.com/dg/216BAA.htm
Doctor's Guide
June 25, 2002


By Bruce Sylvester

Special to DG News

SEATTLE, WA -- June 24, 2002 -- The anti-epileptic drug topiramate (Topamax) provides substantial migraine relief for patients ages 8-10, investigators from Pediatric Epilepsy and Neurology Specialists of Tampa, Fla. reported at the annual meeting of the American Headache Society.

"Topiramate therapy was associated with a substantial reduction in migraine headache frequency and severity, and reduced the degree of associated disability," the researchers wrote.

The research team performed a chart review of pediatric and adolescent patients who had been under care at their clinic for migraine and migraine-like headaches and who had been treated with topiramate. They assessed frequency, severity and disability associated with migraine before and after treatment. They studied the patient charts for comorbid conditions, body weight, adverse events and use of other drugs during treatment.

The investigators identified 10 male and 24 female adolescents, mean age 14 years, who were diagnosed with migraines (16), chronic daily headaches (17) and headaches associated with hydrocephalus (1). The mean dosage for topiramate given to the subjects was between 138 +/- 85 mg (range 15-325 mg).

Upon examining the charts, the researchers found that migraine episode frequency among the topiramate-treated children decreased from a mean of 19.4/month to 4.5/month (77 percent). Mean severity decreased from 2.66 +/- 0.53 to 0.85 +/- 0.82 (68 percent) on a five-point scale. Disability associated with migraine attacks decreased from 2.09 +/- 0.71 to 0.90 +/- 0.61 (71 percent).

Fifteen patients reported adverse events (cognitive slowing, paresthesias, appetite loss and weight loss) -- an incidence of 44 percent. Mean loss of weight was 6 lbs.

The authors concluded that, "A growing body of evidence suggests that topiramate is efficacious in the treatment of migraine both in pediatric and adult patients. This efficacy data, combined with safety data from the use of topiramate in pediatric epilepsy patients, suggests that topiramate may be a primary option in pediatric migraine prophylaxis."

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