The Topamax migraine solution - a dream come true?

An article on the Topamax migraine solution first appeared in our free newsletter HeadWay in the summer of 2003. For current information on migraine issues, sign up today!

Topamax is a relatively new drug geared towards treating seizures. It actually does a number of things, but its action is mainly focused on the nerves, which is where at least part of the migraine problem seems to take place.

Migraineurs have been using various antiepileptic drugs for years. Topamax, which is the brand name for topiramate, has grown in popularity, probably partly due to the fact that it has less serious side effects than most, and also because it has one side effect that many people want – weight loss. The Topamax solution is an attractive one. For many people, the promise that Topamax may decrease their migraine attacks and also help them shed some pounds is like a dream come true.

Dosage for the topamax migraine treatment...

Topamax was approved by the FDA in the USA for migraine treatment in the summer of 2004, but it was commonly used for migraine well before that. Aside for its use as an antiepileptic, topamax migraine treatment is its most common use.

The dosage is usually less than for patients with seizures. Dr. Stephen Silberstein, migraine specialist, recommended 100-200mg per day. This may be given in two doses. The dosage cannot be started or stopped suddenly. Stopping abruptly could cause seizures, even if you've never had them before.

Topamax migraine clinical trials

Dr. Silberstein reported the results of a study in 2002.  The study involved 469 migraineurs, who were given varying doses of topiramate or placebos.  About 50% of them showed a 50% reduction in frequency and duration of their migraine attacks – not bad odds if nothing else works for you!

A study in February 2004 found similar results, with again a 50% reduction in migraines.  10% also lost 4% of their weight, which could be an added bonus for some.

Dr. Merle Diamond and her team did a quality of life study.  Would topiramate actually improve "a patient's ability to function at home, at work, (and) overall to accomplish what they need to"?  734 patients were in the trial, roughly half on a placebo.  Diamond concluded that "the ability to complete daily activities is significantly improved and their quality of life therefore improves."  The dosage Diamond suggests is 100mg in two doses.

Cautions

In spite of all the good news, the Topamax migraine solution should not be the first thing you try. Topiramate is a powerful drug, and there are a lot of solutions that are better to try first.

For example, recently a warning was issued that patients should be watched closely for decreased sweating and hypothermia.  Be sure your doctor is aware of this and that you are being watched for changes in body temperature, especially in hot weather.  Children on this drug should be watched especially closely.  You should also contact your doctor right away if you experience vision problems.

Read this article for more on Topamax side effects.

Some topamax migraine trials have also shown topiramate to be helpful in treating cluster headaches.  Be sure to read our information on other preventative medications.

For more on Topamax, read this topamax migraine article on the MAGNUM website, or visit the website of the manufacturer. Read about a recent clinical trial of topamax at the WebMD website.