Topiramate in Migraine Prophylaxis

Review Article

Mark Obermann , Steffen Naegel, Charly Gaul, and Hans-Christoph Diener

Affiliation : Department of Neurology and Headache Center, University of Duisburg-Essen, Essen, Germany

ABSTRACT

The prevalence of migraine in the global adult population is approximately 10%. Migraine has a serious socioeconomic impact on society in general and is associated with considerable medical disability for individual patients. Migraine is characterized by the combination of typical headache with associated autonomic symptoms and/or the presence of aura. Within the past years, considerable advances were made in understanding the pathophysiology of migraine. This has led to improved treatment options for the acute migraine attack as well as migraine prophylaxis. Topiramate is an antiepileptic drug (AED) with a complex mode of action, which has proven its efficacy and safety in the prophylactic treatment of episodic migraine in a number of randomized controlled clinical trials. Topiramate is also effective in treating patients with chronic migraine with and without medication overuse headache. In clinical trials, it was generally considered to be well tolerated by patients, but in everyday clinical practice, side effects can be therapy-limiting in some patients. Treatment benefits and potential adverse events have to be considered carefully for each individual patient to assure optimal treatment success with topiramate. This is a revised and updated version of a previous review by Naegel and Obermann (2010).


Keywords: topiramate, migraine, migraine prophylaxis, chronic migraine, migraine treatment

Correspondence: Mark Obermann, Department of Neurology, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany.
Tel: (+49)-201-723-84385; Fax: (+49)-201-723-5542; e-mail: mark.obermann@uni-due.de