[Effects of topiramate in the prevention of drug resistant migraine headache]

Migraine is the most common cause of headache. The aim of the present study was to evaluate the effects of topiramate [TPM] in the prevention of drug-resistant migraine headache. This is a double-blind clinical trial conducted on 70 patients between ages 15 to 45 years referred to the Bu Ali Sina Hospital in Sari with a history of migraine attacks based on International Headache Society criteria for a period of more than one years with a minimum incidence of 1 to 6 attacks per month. The drug rate performance was assessed by response rate to treatment, mean changes in the number and severity of migraine attacks compare with the placebo group for 3 months. Collected data were analyzed using analysis of variance [ANOVA], Newman-Keuls and Spearman's Coefficient Rank Correlation as the post hoc tests. GRAPHPAD software was used for analysis of the data. 66 of 70 patients completed the study. The mean age of the patients was 30.33 +/- 7.9 years. A significant reduction in the severity and frequency of migraine attacks was seen in all months [P<0.0001] for topiramate treated group in compare to placebo group. Responder rate for patients treated with TPM was significantly higher than placebo group [64.6%, P<0.0001] in the 3 rd month of the treatment side effects of treatment were transient and well tolerated. Low dose of TPM showed significant efficacy in prevention of migraine attacks within the first, second, and third month of treatment. Low dose of TPM seems to be a good therapeutic option for the patients with refractory migraine