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