Outcomes of topiramate for prophylaxis of chronic migraine headache

OBJECTIVES: To explore the prophylactic outcome and tolerability of topiramate in patients suffering from chronic episodes of migraine. METHODS: A prospective, non-interventional study was conducted at the Neurology Department of Nishtar Medical University & Hospital Multan from 17th Aug 2020 to 17th Aug 2021. The eligible patients were administered topiramate (flexible dose) for six months while the treatment was continued for another six months upon the advice of the physician. The patients were analyzed for improvement in migraine intensity and adverse effects of the evaluated drug at 2(nd), 4(th), 8(th), 12(th) weeks, and at 6(th), 9(th), and 12(th) months. SPSS version 18 was used for statistical analysis RESULTS: Out of the total of one hundred enrolled patients, 30 discontinued the study due to unavoidable adverse effects, loss in the follow-up period, and other unknown reasons. The median endpoint dose was 45 mg/dl ± 20.5mg/day. Both median days with migraine episodes and median pain intensity score significantly reduced from 7 to 1.5 days and from 16 to 2.75, respectively (p<0.01). Women who were found to have menstruation-related migraines reported a decrease in the median number of migraine episodes from 3.0 to 0.8 (p=0.01). The utilization of triptan reduced significantly along with significant improvement in self-reported impairment of life. Nausea (2.5%) and paresthesia (5.7%) were the most reported adverse effects. CONCLUSION: Topiramate not only significantly prevents migraine intensity and frequency of episodes but is also well-tolerated.