MIGRAINE headache is a neurologic disorder associated with significant disability and impaired quality of life, states a recent issue of the Journal of American Medical Association.

Approximately 11 per cent of Americans experience migraine and similar figures have been reported from other countries as well. Many migraine patients do not consult a doctor and take pain killers by buying them over the counter. Besides medication, these people require bed rest during the attack, indicating how migraine can significantly affect their lives.

The goals of treating migraine are to reduce the headache frequency, severity and disability, improve quality of life, reduce distress and psychological symptoms and educate patients and enable them to manage their disease. Habitual overuse of acute medications can lead to the development of chronic daily headaches. Preventive medications thus have an important role in migraine treatment.

Topiramate, a broad spectrum anti-epileptic drug has given encouraging results in migraine prevention. To assess the efficacy and safety of this drug, a study was conducted for 26 weeks on 483 migraine patients with ages between 12 to 65 years. They were divided into four groups, 120 assigned to placebo and 363 received Topiramate in three different doses of 50 mg per day, 100mg/day and 200mg/day.

Topiramate showed significant reductions in the frequency of migraine with very few and mild adverse effects. The drug showed significant efficacy in migraine within the first month of treatment and which was maintained throughout the study period. The dose of 100 mg per day in divided doses proved to be most effective. — Dr Fatema Jawad