Drug update

Topiramate for migraine prevention

Richard Stark

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Abstract

Topiramate is an option for migraine prevention in patients suffering from frequent migraines or when less frequent attacks are so severe in degree as to warrant prophylaxis.

Article Extract

What is topiramate?

Topiramate (Topamax) was introduced as an anticonvulsant in the early 1990s. It has several actions that may be relevant to its anticonvulsant effect, including sodium channel blockade and effects on gamma-aminobutyric acid (GABA) and alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors. As is often the case with migraine prophylactic agents, the basis for its effect in migraine is speculative.

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