Topiramate (Topamax®) is the most important advance in migraine prevention, according to two Norwegian headache specialists writing in The Lancet. The antiseizure drug has long been used to treat epilepsy, but received FDA approval for migraine prevention in 2004.
Topiramate is a cost-effective treatment that lowers the use of health care resources, they wrote. Further, it causes weight loss, unlike many migraine drugs which can lead to weight gain. In clinical trials, two out of three patients lost an average of 5½ pounds.
“Topiramate is a first-line migraine preventive drug in many countries and should especially be considered for adult patients who are overweight, or have epilepsy or a contraindication to beta-blockers,” the authors concluded. “It is generally safe and well tolerated. Data suggest that topiramate could reverse chronic migraine with or without drug overuse to episodic migraine. Thus topiramate is an important drug for difficult cases.”
In related news, Ortho-McNeil Pharmaceutical, LLC, the maker of Topamax, recently reached an agreement with the US government over an investigation of its marketing and promotional practices. It was accused of promoting the drug for certain uses not approved by the US Food and Drug Administration between 2001 and 2003. The company voluntarily discontinued the program at issue before receiving the government’s first subpoena in the investigation and has agreed to pay a financial settlement.