There is sufficient scientific evidence that topiramate is effective in reducing migraine frequency at a dose of 100 mg/day in patients suffering from
Through its wide range of mechanisms of action topiramate increases the activation threshold resulting in neuronal stabilization and thereby reducing cortical
The exact mechanisms by which topiramate exerts pharmacological actions on seizures and migraines are currently not fully characterized
Topiramate's ability to prevent progression from high-frequency episodic migraine to chronic migraine remains unclear
It is thought that topiramate has dual effects on neurotransmission – enhancing inhibitory effects while minimizing excitatory effects, both of which are implicated in
490 Topiramate, 100 or 200 mg/d, was effective as a preventive therapy for patients with migraine
In
The exact mechanism of topiramate is unknown, but several activities are theorized to contribute to its efficacy for migraine prophylaxis
It is taken by mouth as preventive therapy to reduce migraine frequency
Topiramate in the prevention of migraine: a review of its efficacy, tolerability, and acceptability - PMC Journal List Neuropsychiatr Dis Treat v
Topiramate received FDA approval in 1996 for treating epilepsy as monotherapy or adjunctive therapy
We do know that the drug blocks sodium channels that deliver electrical impulses to nerve, muscle, brain, and other excitable cells
Highly effective contraception is required prior to initiation — topiramate can impair the effectiveness of some hormonal contraceptives
1,2
Topiramate is an antiepileptic drug (AED) with multiple mechanisms of action that has been shown to be effective in a number of neuropsychiatric disorders
Approximately 1 in 7 American adults suffer from migraines, and the economic costs in 2016 were estimated to be $36 billion
Patients with migraine without aura and epilepsy were enrolled in this
Schmitt J, et al
In children, a once- or twice-daily dose of 25 mg topiramate or 250 mg valproate in a sustained-release form is effective for migraine prophylaxis
Since 2012, the extended-release formulation has been approved in combination with [ phentermine] for chronic weight management therapy in adults
Its efficacy in chronic migraine is not improved by the addition of propranolol
Topiramate has multiple mechanisms by which it is effective in the treatment of migraine
The critical mechanism that underlies the generation of aches in migraine is hypothesized as the activation of trigeminal sensory pain pathways that occur due to the local widening of intracranial extracerebral blood vessels
Among neuromodulators used for migraine prevention, topiramate has a high level of evidence-based efficacy