Low‐Dose Topiramate Versus Lamotrigine in Migraine Prophylaxis (The Lotolamp Study)

Gupta, Praveen; Singh, Sumit; Goyal, Vinay; Shukla, Garima; Behari, Madhuri

doi:10.1111/j.1526-4610.2006.00599.x

Cited by 76 publications

(71 citation statements)

References 26 publications

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“…A second, new Class I study comparing lamotrigine 50 mg/day with placebo or topiramate 50 mg/day reported lamotrigine was not more effective than placebo (for both primary endpoints) and was less effective than topiramate in reducing migraine frequency and intensity. 14 The primary outcome measure (responder rate: Ն50% monthly migraine frequency reduction) was 46% for lamotrigine vs 34% for placebo ( p ϭ 0.093, CI 0.02-0.26) and 63% for topiramate vs 46% for lamotrigine ( p ϭ 0.019, CI 0.03-0.31). Treatment-related AEs (rash, giddiness, sleepiness, and gastrointestinal intolerance) occurred in 10% of patients on lamotrigine.…”

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confidence: 99%

“…18 In a second placebo-controlled Class I double-crossover study (reviewed above), topiramate was more effective than placebo and lamotrigine for primary efficacy measures. 14 In the topiramate groups, 15% of patients experienced AEs, most commonly paresthesias, sleepiness, and gastrointestinal intolerance. The placebo group reported gastrointestinal intolerance (3%) and anorexia (3%).…”

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confidence: 99%

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Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults

et al. 2012

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Objective: To provide updated evidence-based recommendations for the preventive treatment of migraine headache. The clinical question addressed was: What pharmacologic therapies are proven effective for migraine prevention? Methods:The authors analyzed published studies from June 1999 to May 2009 using a structured review process to classify the evidence relative to the efficacy of various medications available in the United States for migraine prevention. Results and Recommendations:The author panel reviewed 284 abstracts, which ultimately yielded 29 Class I or Class II articles that are reviewed herein. Divalproex sodium, sodium valproate, topiramate, metoprolol, propranolol, and timolol are effective for migraine prevention and should be offered to patients with migraine to reduce migraine attack frequency and severity (Level A). Frovatriptan is effective for prevention of menstrual migraine (Level A). Lamotrigine is ineffective for migraine prevention (Level A). Neurology Epidemiologic studies suggest approximately 38% of migraineurs need preventive therapy, but only 3%-13% currently use it.1 In 2000, the American Academy of Neurology (AAN) published guidelines for migraine prevention.2,3 Since then, new clinical studies have been published on the efficacy and safety of migraine preventive therapies. This guideline seeks to assess this new evidence to answer the following clinical question: For patients with migraine, which pharmacologic therapies are proven effective for prevention, as measured by reduced migraine attack frequency, reduced number of migraine days, or reduced attack severity? This article addresses the safety and efficacy of pharmacologic therapies for migraine prevention.Separate guidelines are available for botulinum toxin. 4 The 2008 guideline included a Level B recommendation that botulinum toxin was probably ineffective for treatment of episodic migraine. A new guideline is in development. An updated guideline on nonsteroidal anti-inflammatory drugs 5 and complementary alternative treatments has been approved for publication as a companion to this guideline. 5 DESCRIPTION OF THE ANALYTIC PROCESSThe AAN and the American Headache Society participated in the development process. An author panel of headache and methodologic experts was assembled to review the evidence. Computerized searches of the MEDLINE, PsycINFO, and CINAHL databases identified new studies (published in English). The search strategy used the MeSH term "headache" (exploded) and a published search strategy for identifying randomized controlled trials ( Appendices e-1-e-5, reference e1, and tables e-1 and e-2 are available on the Neurology Web site at www.neurology.org.

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Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults

et al. 2012

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“…Oxcarbazepine was not effective for migraine prophylaxis in a placebo-controlled trial. 28 Lamotrigine was less efficacious for migraine than topiramate in a small double-blind placebo-controlled trial and only marginally better than placebo, 29 confirming the general clinical impression that lamotrigine has low efficacy for migraine.…”

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confidence: 69%

Choosing Among Antiepileptic Drugs

Fountain¹

2010

CONTINUUM: Lifelong Learning in Neurology

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Selecting an antiepileptic drug (AED) for treatment of seizures is daunting because there are now 20 from which to choose. Following simple principles allows a systematic approach to drug selection. Efficacy studies provide limited information. For initial monotherapy of partial seizures, high-level evidence exists for the efficacy of lamotrigine, carbamazepine, oxcarbazepine, and topiramate. For initial monotherapy of generalized seizures, high-level evidence is available for valproate, lamotrigine, topiramate, and oxcarbazepine. For initial monotherapy of absence seizures, high-level evidence exists for valproate, lamotrigine, and ethosaximide. All second-generation AEDs have efficacy as adjunctive therapy for partial seizures. AEDs are often useful for comorbid conditions or have properties that should be avoided in some groups. Thus, AEDs should usually be selected on the basis of comorbid conditions, including depression, migraine, chronic pain, obesity, and nephrolithiasis, or patient characteristics, especially for women of childbearing potential and older adults.

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“…Lamotrigine is up to now the only preventive drug which has been shown effective for migraine auras (D'Andrea et al 1999;Lampl et al 2005) but not for migraine without aura (Steiner et al 1997;Gupta et al 2007).…”

Section: Drug Treatmentsmentioning

confidence: 99%

Current migraine management – patient acceptability and future approaches

Fumal

Schoenen

2008

NDT

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Despite its high prevalence and individual as well as societal burden, migraine remains underdiagnosed and undertreated. In recent years, the options for the management of migraine patients have greatly expanded. A number of drugs belonging to various pharmacological classes and deliverable by several routes are now available both for the acute and the preventive treatments of migraine. Nevertheless, disability and satisfaction remain low in many subjects because treatments are not accessible, not optimized, not effective, or simply not tolerated. There is thus still considerable room for better education, for more effi cient therapies and for greater support from national health systems. In spite of useful internationally accepted guidelines, anti-migraine treatment has to be individually tailored to each patient taking into account the migraine subtype, the ensuing disability, the patient's previous history and present expectations, and the co-morbid disorders. In this article we will summarize the phenotypic presentations of migraine and review recommendations for acute and preventive treatment, highlighting recent advances which are relevant for clinical practice in terms of both diagnosis and management.

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Low‐Dose Topiramate Versus Lamotrigine in Migraine Prophylaxis (The Lotolamp Study)

Abstract: Low-dose topiramate is efficacious in migraine prophylaxis as compared to both placebo and lamotrigine. Lamotrigine in low doses might be beneficial for headache frequency; however, longer trials are required to establish its efficacy on the intensity and frequency of migraine.

Cited by 76 publications

References 26 publications

Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults

Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults

Choosing Among Antiepileptic Drugs

Current migraine management – patient acceptability and future approaches

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Low‐Dose Topiramate Versus Lamotrigine in Migraine Prophylaxis (The Lotolamp Study)

Abstract: Low-dose topiramate is efficacious in migraine prophylaxis as compared to both placebo and lamotrigine. Lamotrigine in low doses might be beneficial for headache frequency; however, longer trials are required to establish its efficacy on the intensity and frequency of migraine.

Cited by 76 publications

References 26 publications

Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults

Evidence-based guideline update: Pharmacologic treatment for episodic migraine prevention in adults

Choosing Among Antiepileptic Drugs

Current migraine management &ndash; patient acceptability and future approaches

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Product

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Current migraine management – patient acceptability and future approaches