Topiramate: the evidence for its therapeutic value in the prevention of migraine

Nadin, C

doi:10.2147/ce.s7413

Cited by 2 publications

(2 citation statements)

References 53 publications

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“…70 Topiramate was first approved in 1996 as an antiepileptic drug and was later approved in 2004 for migraine prophylaxis in adults. 1,71 Not many studies have been conducted to compare the effectiveness of Melatonin with Topiramate. In a study conducted by Alkhaffaf et al 1 to compare the effectiveness and tolerability of these drugs as monotherapy in migraine prophylaxis and to support the use of Melatonin as preventive therapy.…”

Section: Resultsmentioning

confidence: 99%

Melatonin: Role in the Prophylaxis of Migraine

Sati,

Jauhari,

Rao

et al. 2022

J App Pharm Sci Res

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Melatonin and migraine have been linked in most ways, from mechanisms to treatment. Migraine is one of the common neurological diseases and it is characterized by throbbing unilateral headache attacks. Migraine is an issue for both individuals and society. Migraine can lead to reduced work productivity and a flawed family and social life. It has been suggested that melatonin plays a key therapeutic role in treating migraines and several other types of headaches. Early and exact diagnosis is essential in enhancing treatment and in preventing progression. This review aimed to evaluate the available evidence related to the efficacy and safety of melatonin in the prophylaxis and prevention of migraine. Research in regard the administration of melatonin found it safe in migraine patients, with few or no side effects. This review concluded that Melatonin can be considered a safe integrative prophylactic treatment for children, adults and menstrual-related migraines, thus improving outcomes related to patient’s quality of life and patient-centered care. However, further studies and evaluation is required to confirm its effects.This review aimed to evaluate the available evidence related to the efficacy and safety of melatonin in migraine prophylaxis. Melatonin and migraine have been linked in a majority of ways, from mechanisms to treatment. Melatonin is an endogenous hormone and is secreted by the pineal gland. It plays an important role in regulating circadian rhythm and the sleep-wake cycle. It has been proposed for migraine prevention due to its anti-inflammatory effects against calcitonin gene-related peptides and other pro-inflammatory mediators in vitro, and its pro-regulatory effect on the circadian rhythm. Also, low melatonin levels have been reported in serum and urine due to hypothalamic dysfunction in patients with migraine. Hence, in this article, we review those papers describing the results of the administration of melatonin in humans for therapeutic purposes in treating migraines.This narrative literature review was based on studies on Melatonin's effectiveness, safety and tolerability for the prophylactic and preventive treatment of migraine in children and adolescents and menstruating women. The literature search was conducted using the Google Scholar and PubMed database and included articles published up to December 2021, utilizing the keywords: “melatonin”, “migraine”, “melatonin and migraine”, and “prophylaxis of migraine”. Observational studies, randomized controlled trials (RCTs), case reports and systematic reviews were included. The articles focusing on the latest medication for preventing migraines were also reviewed.

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Section: Resultsmentioning

confidence: 99%

Melatonin: Role in the Prophylaxis of Migraine

Sati,

Jauhari,

Rao

et al. 2022

J App Pharm Sci Res

View full text Add to dashboard Cite

show abstract

“…It was originally approved in 1996 by the Food and Drug Administration for the treatment of epilepsy (US Food and Drug Administration, n.d.-a). In 2004, the drug was approved for the prophylaxis of migraine headache (Nadin, 2005), and in 2012, it was approved in combination with phentermine for weight loss (Alfaris et al, 2015). Across these multiple indications, from 2014 to 2019, there were over 8 million topiramate prescriptions filled annually in the United States (Kane, n.d.).…”

Section: Introductionmentioning

confidence: 99%

Effects of topiramate therapy on serum bicarbonate concentration in a sample of 10,279 veterans

Naps

Leong²,

Hartwell

et al. 2023

Alcohol: Clinical and Experimental Research

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Background: Topiramate, which is increasingly being used to treat alcohol use disorder (AUD), is commonly associated with reduced serum bicarbonate concentrations.However, estimates of the prevalence and magnitude of this effect are from small samples and do not address whether topiramate's effects on acid-base balance differ in the presence of an AUD or by topiramate dosage. Methods: Veterans Health Administration electronic health record (EHR) data were used to identify patients with a minimum of 180 days of topiramate prescription for any indication and a propensity score-matched control group. We differentiated patients into two subgroups based on the presence of a diagnosis of AUD in the EHR. Baseline alcohol consumption was determined using Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) scores in the EHR. Analysis also included a three-level measure representing mean daily dosage. The topiramate-associated changes in serum bicarbonate concentration were estimated in difference-in-differences linear regression models. A serum bicarbonate concentration <17 mEq/L was considered to represent possible clinically significant metabolic acidosis. Results: The cohort comprised 4287 topiramate-treated patients and 5992 propensity score-matched controls with a mean follow-up period of 417 days. The mean topiramate-associated reductions in serum bicarbonate concentration were <2 mEq/L in the low (≤88.75), medium (>88.75 and ≤141.70), and high (>141.70) mg/day dosage tertiles, irrespective of AUD history. Concentrations <17 mEq/L occurred in 1.1% of topiramate-treated patients and 0.3% of controls and were not associated with alcohol consumption or an AUD diagnosis. Conclusions: The excess prevalence of metabolic acidosis associated with topiramate treatment does not differ with dosage, alcohol consumption, or the presence of an AUD. Baseline and periodic serum bicarbonate concentration measurements are recommended during topiramate therapy. Patients prescribed topiramate should be educated about the symptoms of metabolic acidosis and urged to report their occurrence promptly to a healthcare provider.

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Topiramate: the evidence for its therapeutic value in the prevention of migraine

Cited by 2 publications

References 53 publications

Melatonin: Role in the Prophylaxis of Migraine

Melatonin: Role in the Prophylaxis of Migraine

Effects of topiramate therapy on serum bicarbonate concentration in a sample of 10,279 veterans

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