Migraines? Ask Your Doctor About TPM

Neuroscience_Neurology2.jpgAre 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.

  • drug rehabilitation

    I’ve got headaches so often oh….. i could of banged my head to the wall and it wouldn’t hurt not even close …

  • Or, to avoid medications if they aren’t absolutely necessary — consider a neurofeedback — brain-based biofeedback — technique called hemoencephalography or HEG.

    HEG is a safe, noninvasive, biofeedback technique that works by increasing the brain’s ability to prevent the activity that results in migraine pain. It is effective for both “classical” migraines and for post-traumatic headaches such as those after motor vehicle collisions.

    In a study of 100 people, 94% experienced significant improvement in either the severity and/or the frequency of headaches after 6 sessions.

    In my own practice, this number holds and most people are able to either discontinue using medications or go from using them weekly or more often to using them every few months.

    Just wanting to share another alternative with no side-effects — unless you count it’s “side-benefits” of improving the brain’s “executive functions” (i.e., planning, organization, attention…). I do have an article on my blog that tells more about it and shows infrared images of the brain before and after training, for those that might be interested, if I may post the link:

    Do You Need to Tolerate Migraines?: http://www.brainandhealthblog.com/2005/10/06/do-you-need-to-tolerate-migraines/

    Thanks for sharing more options!

  • Haley Malcolm

    A high school student, I suffer from blinding migraines often in the middle of class. Is topiramate safe for teenagers? Is the relief worth the side effects? I want to find something that will help me, but I can’t risk the side effects of some of the other mediences that I have tried.

  • snow

    I had an fMRI and suffered severe headache, burning sensation and brain fog afterwards. I did this as a volunteer in a research study and have never had headaches before. Ever heard of this? It was SEVERE for about 2 weeks and still feels weird but not as bad.

Larry Leonard

Larry Leonard is a retired navy air traffic controller, licensed pilot, EMT, husband, and father to five boys. He served in the Vietnam area during the war and in the gulf during the Gulf War.

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