Topiramate in migraine prevention: evidence-based medicine from clinical trials.
Author(s): Silberstein SD(1).
Affiliation(s): Author information:
(1)Department of Neurology, Thomas Jefferson University Hospital, Philadelphia,
PA 19107, USA. Stephen.Silberstein@jefferson.edu
Publication date & source: 2004, Neurol Sci. , 25 Suppl 3:S244-5
The importance of evidence-based medicine is often underestimated when migraine
preventive treatments are chosen. Evidence from large, well-conducted,
placebo-controlled trials of sufficient duration should be given particular
consideration when evaluating the efficacy, tolerability and safety of a
medication for a broad range of patients. Pizotifen, propranolol, flunarizine,
amitriptyline, divalproex sodium and topiramate have all been evaluated for
efficacy in migraine prevention in double-blind, placebo-controlled trials. The
largest clinical programme in migraine prevention, studying these or any other
agents, was comprised of 2 pivotal trials, as well as other studies, evaluating
topiramate for preventive therapy in migraine. Results from these trials
indicated that topiramate (100 mg/day) has proven safety and efficacy in migraine
prevention. Response rates were high, and onset of action usually occurred within
the first month of treatment. Therefore, topiramate has demonstrated safety and
represents an effective option in the prevention of migraine, as supported by
extensive clinical research.
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