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        New Message Board Archives >> Medications, Treatments, Therapies 2003 >> Topiramate:  New Study
        
(Message started by: dougW on Jul 27^th, 2003, 12:11pm)

Title: Topiramate: New Study
Post by dougW on Jul 27^th, 2003, 12:11pm

As reported this week in the Journal Headache.

Note the limited patient base, and the high drop out rate due to side effects. Note also ..."All patients had been treated with some preventive treatment, with poor or no response. Sorry, no breakdown on responses of episodic vs chronic????

May be worth considering, time for another visit to a Doc?

Headache: The Journal of Head and Face Pain
Volume 43 Issue 7 Page 784 - July 2003
doi:10.1046/j.1526-4610.2003.03137.x

Topiramate in the Prophylactic Treatment of Cluster Headache
Miguel J. A. Láinez, MD, PhD; Julio Pascual, MD, PhD; Ana M. Pascual, MD; Jose M. Santonja, MD; Alejandro Ponz, MD; Antonio Salvador, MD

Objective.The role of topiramate in the prophylactic treatment of cluster headache is still unclear. The aim of this study was to evaluate the effectiveness of topiramate in a group of patients with refractory episodic or chronic cluster headache.

Background.Proof of efficacy of preventive treatment of cluster headache is limited, especially for the chronic form of the disorder. There are very few randomized clinical trials on this condition with topiramate or other new anticonvulsant agents. Recent case reports and series involving topiramate have shown good results. The mechanism of action of topiramate is unknown, but is presumably mediated by -aminobutyric acid.

Methods.Twenty-six patients with episodic (n = 12) or chronic (n = 14) cluster headache were studied prospectively. All patients had been treated with some preventive treatment, with poor or no response. Treatment with topiramate was initiated with 25 mg once a day, and the dose was titrated every 3 to 7 days to a maximum of 200 mg, according to clinical response and tolerability.

Results.Topiramate rapidly induced cluster remission in 15 patients, reduced the number of attacks more than 50% in 6 patients, and reduced the cluster period duration in 12. The mean time to remission was 14 days (range, 1 to 27), but in 7 patients remission was obtained within the first days of treatment with very low doses (25 to 75 mg a day). Tolerability was good within the lower range of doses used. Six patients discontinued treatment due to side effects (all with daily doses over 100 mg) or lack of efficacy.

Conclusions.Our results confirm that topiramate can be an effective option for the preventive treatment of episodic and chronic cluster headache.

Title: Re: Topiramate: New Study
Post by Prense on Jul 28^th, 2003, 6:32pm

Chronic here...side effects suck, but I guess it's working so far after two weeks. First week, had three HAs, then 7 days PF and counting..........

That's on 200mg and it goes up to 300mg on friday and stays there for ummm, hell I don't know...forever??? Doc?!?!?!?

Oh, and "Doc" is soon to be replaced btw...just had to throw that in there :P

Title: Re: Topiramate: New Study
Post by chanel on Aug 4^th, 2003, 2:31pm

Out of all of the "prophylactic" medications I've tried in the past five years, Topamax has seemed to make the biggest positive difference in my condition. If I go off of it for awhile (mostly due to the cost of the medication and my lack of perscription coverage) I see an immediate difference (for the worse) in the frequency and potency of my HAs. It has shown me some negative side effects. Lethargy and a feeling of "being a zombie" mostly, but I'll take that over the pain ANY day.

I'm on 300mg/day.

Title: Re: Topiramate: New Study
Post by MarkV on Aug 4^th, 2003, 7:46pm

I see very few posts on topamax other than positive in general. I have had very positive results with topamax making my CHs tolerable to the point they were almost non-existent. It took me 3 months to get over the side effects though to the point I could feel somewhat normal. I still have a very difficult time dealing with the weird emotional side effects and I'm only on 100mg/day. I'm happy for those who don't have to deal with this - seems like a lot don't have any of these effects at all.

For those who haven't tried it, and its prescribed, best of luck - might be the best thing for you. I've seen some archive posts from people say good things about topamas and just disappear from the board. Is it because they don't have problems anymore and just stay on topamax???

I've stayed off the board for the last 6+ months for similar reasons (I've been having fun enjoying myself headache free for one summer - although I'm sure it won't last???).

Wish you all the best,
MarkV

Title: Re: Topiramate: New Study
Post by Lori on Aug 14^th, 2003, 7:12pm

I am very encouraged to read this. I used topomax (100MG) during my last cycle along with verapamil. Together, I suffered a few breakthroughs that were less painful and once my dosage was at 100mg, I was almost completely painfree for the rest of my cycle. I did have alot of side effects though and I have been wondering if I should try something different if I get another cycle (I always like to say if) or stick with the topomax. I agree I'd rather have the side effects of the meds vs the pain any day! I still wonder though if something else might give me the relief without the side effects. Anyway, good to hear others are having good results with it.

Title: Re: Topiramate: New Study
Post by Karla on Aug 15^th, 2003, 6:34am

My neuro at the ha clinic had me on 600mg of topamax. Almost made me crazy. I couldn't stand the side effects. One nasty medicine.

Title: Re: Topiramate: New Study
Post by Lori on Aug 15^th, 2003, 12:45pm

600mg! Yeah, that would make me crazy too. 100 mg was bad enough, but I must also add that after a few weeks at the 100mg, the side effects did seem to decrease a lot. It was tolerable then at least.

Title: Re: Topiramate: New Study
Post by Prense on Aug 15^th, 2003, 9:04pm

I ended up getting taken off of Topamax due to side effects. :( While I was on this med, I must say that I felt HORRIBLE. I went on a nasty side-effect roller coaster ride from hell. The key though is how it is prescribed progressively...my neuro screwed that up, and now he is no longer my neuro. I didn't notice any decline in severity/frequency over the entire time I took this med, but I wasn't on it long enough either.

Chris