Teen Eating Disorders The Food and Drug Administration recently approved topiramate for migraine prevention in adolescents, but a recent report has raised concerns that it may increase the risk of eating disorders in some teens. Writing in the journal Pediatrics, Jocelyn Lebow, PhD, a child and adolescent psychologist at the University of Miami Miller School of Medicine, reviewed the case histories of seven young women, ages 13 to 18, whose eating disorders developed or were exacerbated after they began taking topiramate.

  Eye Exam Q. I noticed that shortly after starting Topamax, I saw flashing lights in my vision, as if someone were taking a picture with a flash. I was told it had nothing to do with Topamax or my eyes, but I would like to know if anyone else has heard of this occurrence. My migraines occur every other day. I had a Botox treatment a few weeks ago, and nothing seems to help. I consulted an ophthalmologist and was told that I do not have any problems with my eyes aside from cataracts. In the past, I have suffered head trauma—once as a child and later in a car accident. Is the flashing light in my eyesight a side effect of Topamax, or just migraine? I took one less Topamax pill and noticed that I didn’t have the flashing for as long. If this is a side effect from the medication, is there an alternative therapy that can be prescribed? Also, would acupuncture help? Other medications I’ve taken are atenolol, nortriptyline and valproate.

Q. I have had migraines for approximately 20 years. I have bad months in which I have 6-10 days of headaches. The last month has been better since I started on Topamax for migraine prevention. However, I am feeling anxious and wondering if there is an anti-anxiety medication that is recommended. What are your thoughts about BuSpar and Paxil?

Q. I have been reading NHF’s HeadWise for a few years now and find it very informative and helpful. I wish I didn’t need the information, but I have been diagnosed with cluster migraines. True to pattern, I can go two to three years without migraines except for two to three migraines per month occurring prior to my period. The clusters occur two to three times a day for a few months then remit for a couple of years. After every cluster, I always hope it will be my last time. Are they ever going to stop? Does a person outgrow them? I am currently taking amitriptyline daily, Imitrex® as needed and have just started Topamax® as a preventive when a cycle strikes.

The U.S. Food and Drug Administration (FDA) recently approved Topamax (topiramate) for prevention of migraine headaches in adolescents ages 12 to 17. Topiramate is the first drug to earn FDA approval for migraine prevention in this age group. Although it was prescribed for young migraineurs before the approval, this step is expected to provide benefits to physicians and patients.

Q. My adult daughter has had a headache for six months. It never goes away, no matter what she takes. Her primary doctor gave her a prescription for a limited number of Vicodin®, which dulls the pain a little, and she takes a muscle relaxant. She had her first migraine with aura at age 20 and until this year only got a migraine about twice a year. I thought she got off easy compared to her oldest sister, who suffered from severe migraine all through high school, and her other sister who outgrew cyclic vomiting syndrome. My daughter has had all the tests you can imagine and is seeing a neurologist who diagnosed her with chronic daily migraine. He says the next step is to start Topamax® and increase by increments, up to 200 mg. I’m concerned because she previously tried Topamax, up to 50 mg, but experienced tingling in her hands and nausea. My daughter’s quality of life is suffering and we are desperate to obtain relief for her. Do you have any advice?

The US Food and Drug Administration (FDA) has issued a new warning about possible birth defects linked to topiramate (Topamax®), an antiseizure drug that is used to prevent migraine as well as treat epilepsy. The warning came after two pregnancy registries found an increased risk of oral clefts (cleft lip and cleft palate) in babies whose mothers had taken topiramate while pregnant.

Q. I am a frequent migraine sufferer and have had no luck in finding a treatment that works for me. I've had massage therapy, acupuncture, and been to my primary care doctor and a neurologist. I've been on a daily preventive (Topamax®), which did nothing for the headaches, but did make me sick! I now take Maxalt® when I feel a bad migraine coming on, but it doesn't work as well as it did when I first started taking it. Is there something else I can try? I'm ready to bang my head against a wall!

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.