Topiramate in patients with episodic migraine: Reducing the risk for chronic forms of headache

Abstract

Objective. - The aim was to evaluate whether preventive treatment with topiramate in patients with episodic migraine reduces the risk of developing chronic forms of headache. Background. - Chronic forms of headache, including chronic migraine or medication overuse headache (MOH), are characterized by 15 or more headache days per month. Acute medication overuse has been shown to be a risk factor for developing chronic headache, but it is not known whether preventive treatment can reduce the risk of developing chronic forms of headache or the development of MOH. Methods. - Pooled data from 3 trials in patients with episodic migraine randomized either to treatment with 100 mg topiramate per day (n = 384) or with placebo (n = 372) were analyzed with regard to the number of headache days during a prospective 4-week baseline period and the individual final 4 weeks of each patient's treatment during the planned 26-week double-blind treatment period. Results. - The number of headache days per month in the topiramate versus the placebo-treated groups was 7.3 ± 3.0 versus 7.3 ± 3.1 during baseline and 4.1 ± 4.2 versus 5.6 ± 4.9 during the final 4 weeks, respectively (P