Migraines? Ask Your Doctor About TPM

Are you among the nearly twelve percent of the adult population who suffer from migraines? If so, read on.

The migraine is a highly prevalent, disabling, undiagnosed, and undertreated disease, with considerable economic and social impact. Treatment strategies are both preventive and acute, using a plan that usually includes educating patients about their illness and its management (for instance, mechanisms, recognizing and avoiding triggers, and lifestyle changes), acute treatment, and preventive treatment. During a migraine attack, nerves in the brain dilate blood vessels that, in turn, cause pain, further nerve activation, and inflammation. Because nerve events are linked to circulatory system events, migraine is a neurovascular headache disorder. Current prescriptions such as aspirin, acetaminophen, nonsteroidal anti-inflammatory drugs, opiates, combination analgesics, and migraine-specific treatments (ergotamine, dihydroergotamine, and the triptans) are used.

In 2006, the U.S. Food and Drug Administration approved topiramate (brand name Topamax), also known as TPM, in 25-, 100-, and 200-mg tablet formulations for migraine prevention. TPM is rapidly and almost completely absorbed after oral administration and readily penetrates the central nervous system. It is a neuromodulator with a structurally unique formula that provides multiple mechanisms of action and can influence the electrical activity in the brain by binding to the membrane.

Test participants experienced a significant reduction in the frequency of migraine headaches, number of migraine days, and use of acute medications. But there’s more good news: TPM is effective for patients who are concerned about gaining weight, are currently overweight, or have coexisting epilepsy. TPM should also be useful for children with migraines.

Reference

Bigal, M. E. & Krymchantowski, A.V. (2006). Emerging drugs for Migraine Prophylaxis and Treatment. Medscape General Medicine, 8(2):31. Posted 5-4-06.