Topiramate in the treatment of refractory chronic daily headache. An open trial.

Abstract

Chronic daily headache (CDH) is a debilitating disorder that becomes a treatment challenge in patients refractory to the treatment. We hereby report our experience with topiramate treatment in patients with refractory CDH. The study design was a prospective, protocol-based follow-up and retrospective analysis of headache diaries. We treated with topiramate at slowly increased moderate increments 11 CDH patients who were refractory to multiple previous treatments. Topiramate treatment was effective in 7 (64%) patients. The treatment resulted in a 66% (median) decrease of the headache days per week and a significant decrease in headache severity, a reduction of the headache hours per day, and weekly analgesic consumption. These effects continued for an average follow-up of 8+/-4 months. The average effective dose was 100 mg/day. Slowly increasing the drug at moderate increments resulted in high tolerability of topiramate. We found topiramate to be an effective long-standing treatment option for patients with refractory CDH. Slow increments of the dosage contributed to high tolerability of the drug.

• Authors: Amnon Mosek, Marina Dano
• Journal: The journal of headache and pain (J Headache Pain) Vol. 6 Issue 2 Pg. 77-80 (Apr 2005) ISSN: 1129-2369 [Print] England
• PMID: 16362646 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Analgesics
• Anticonvulsants
• Topiramate
• Fructose

Topics

• Adult
• Aged
• Analgesics (administration & dosage)
• Anticonvulsants (administration & dosage, adverse effects)
• Dose-Response Relationship, Drug
• Female
• Fructose (administration & dosage, adverse effects, analogs & derivatives)
• Headache Disorders (drug therapy, physiopathology)
• Humans
• Male
• Middle Aged
• Pain, Intractable (drug therapy, physiopathology)
• Topiramate
• Treatment Outcome