Preventing Disturbing Migraine Aura With Lamotrigine: An Open Study

Pascual, Julio; Caminero, Ana B.; Mateos, V.; Roig, Carlos; Leira, Rogelio; García-Moncó, C.; Láinez, Miguel J. A.

doi:10.1111/j.1526-4610.2004.04198.x

Cited by 86 publications

(55 citation statements)

References 25 publications

(44 reference statements)

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“…This consideration addressed us in the past to use in these three of our BM patients lamotrigine, effective drug in preventing migraine aura and cortical spreading depression and in reducing migraine headache frequency [4]. After open study by Pascual et al [5] on lamotrigine use for the preventive treatment of selected patients with disturbing migraine auras, including those with BM and hemiplegic migraine, no other clinical trials have been reported in the literature. Other anticonvulsant drugs have been tested in BM such as sodium valproate [6] and topiramate in a child population [7] with a good response at both 25 and 100 mg doses.…”

Section: Discussionmentioning

confidence: 99%

Basilar-type migraine patients responsive to lamotrigine: a 5-year follow-up

et al. 2013

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Five years ago we reported the case of three patients affected by basilar-type migraine (BM) responsive to lamotrigine. At that time, proven treatment options for BM are rather limited and lamotrigine has been tested in BM patients because it was a widely tested treatment for migraine with aura. That positive 1-year experience leaded us to suggest that lamotrigine could be a preventive therapeutic option for BM patients, with and without menstruation association. We now report the five-year follow-up of the same patients to confirm and underlie the possible role of lamotrigine to induce BM attacks remission.

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Section: Discussionmentioning

confidence: 99%

Basilar-type migraine patients responsive to lamotrigine: a 5-year follow-up

et al. 2013

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“…His headaches began at age 9 while under the care of pediatric neurologist in Charleston, West Virginia. His condition worsened after a motor vehicle accident, particularly the headaches of which he had [3,4] bad ones per week. Neurontin, 400 mg, two tablets three times per day and 400 mg of felbamate daily did not reduce the headaches in number or in severity nor did the seizures changed.…”

Section: Casementioning

confidence: 99%

“…Thus, a ketogenic diet has been found effective in preventing the migraines and the ensuing epilepsy [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Successful Opioid Monotherapy in Migralepsy: A Case Series

Derakhshan¹

2016

J Neurol Disord

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Background: There is a consensus that migraine and epilepsy are comorbid conditions. The novel concept explored and developed in this case series is that of the primacy of headaches in generating seizures in those patients suffering from migraine-triggered epilepsy (i.e., migralepsy). As demonstrated in the five cases descried here, much like the effect of ketogenic-diet on migraine-triggered epilepsy, once the migraine headaches were completely suppressed after adopting daily scheduled opioid therapy the seizures stopped from occurring, but they returned with the recurrence of the migraines once the patients had stopped their daily opiate regimen for any reason.

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“…Comparison of fi ndings from the two studies showed that response rates for 2-hour pain relief, 2-hour pain free and SPF were higher for the patients receiving treatment from the PCPs than those treated by the neurologists ( fi g. 1 ) [19,20] . These results suggest that the patients receiving therapy from the neurologists are more diffi cult to treat than those who are seen by the PCPs.…”

Section: Spanish and German Postmarketing Surveillance Studiesmentioning

confidence: 99%

“…Two multicenter, open-label observational PS studies of the effi cacy and tolerability of almotriptan 12.5 mg in the acute treatment of migraine have been conducted in Spain [19,20] . The fi rst study recruited patients receiving headache treatment from neurologists, and approximately 1,000 were analyzed for effi cacy (intent-to-treat analysis).…”

Section: Spanish and German Postmarketing Surveillance Studiesmentioning

confidence: 99%

Efficacy and Tolerability of Almotriptan in Postmarketing Surveillance Studies

Pascual¹

2005

Eur Neurol

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While randomized, double-blind, placebo-controlled trials are considered the gold standard of clinical evidence, they are limited by patient numbers, duration of patient exposure, and restricted patient populations. Data from controlled trials may not be generalizable to all individuals likely to take the drug under investigation. Postmarketing surveillance studies are designed to measure efficacy and safety in larger and more diverse populations, allowing them to detect less common and delayed adverse events. However, postmarketing surveillance studies are limited by their lack of randomization, open-label design that can result in patient and physician bias, incomplete follow-up, less than rigorous outcome measurement, and lack of a contemporaneous control group. With regard to acute treatment of migraine, clinical trials using per protocol primary endpoints do not reflect the more favorable experience with triptans in general practice. Postmarketing surveillance studies have been performed to determine whether the high levels of efficacy and tolerability of almotriptan reported in controlled clinical trials can been reproduced in routine practice. An observational study conducted in Spain with 2,074 migraine sufferers (4,183 attacks) reported a 2-hour pain-relief rate of 86.9%, a 2-hour pain-free rate of 51.5%, and a sustained pain-free rate of 46.0%; 1.1% of patients reported adverse reactions. A German postmarketing study in 899 patients (2,131 attacks) with acute migraine treated with almotriptan 12.5 mg reported 2-hour pain relief in 84.5% of attacks and 2-hour pain free in 41.4%; 1.1% of patients reported adverse reactions. The consistency of response (at least two out of three attacks successfully treated) with almotriptan 12.5 mg was 87.3%. Regarding satisfaction, 88.5% of patients were satisfied or very satisfied and 80.3% of patients stated that almotriptan was better compared to their prior therapy; 92% of physicians indicated that they would continue treating their patients’ migraines with almotriptan. The results of these studies demonstrate that the high levels of efficacy and tolerability seen with almotriptan in controlled clinical trials are achieved in real-world clinical settings. In conclusion, a combination of controlled clinical trials, postmarketing surveillance studies, and physician’s experience in the general population can give us a better understanding of the efficacy and tolerability of acute migraine agents.

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Preventing Disturbing Migraine Aura With Lamotrigine: An Open Study

Abstract: Lamotrigine should be considered in clinical practice for the preventive treatment of selected patients with disturbing migraine auras. Lamotrigine seems worthy of a controlled trial as prophylaxis of migraine aura.

Cited by 86 publications

References 25 publications

Basilar-type migraine patients responsive to lamotrigine: a 5-year follow-up

Basilar-type migraine patients responsive to lamotrigine: a 5-year follow-up

Successful Opioid Monotherapy in Migralepsy: A Case Series

Efficacy and Tolerability of Almotriptan in Postmarketing Surveillance Studies

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