Outcome of topiramate in migraine prophylaxis

Background: Topiramate is an antiepileptic medication originally and one of the first-line drugs for migraine prophylaxis. Herein, we aimed to assess the outcome of topiramate in migraine prophylaxis by evaluating the reduction in frequency and/or severity of attacks and addressing the most common adverse effects associated with it. Methods: A descriptive, prospective hospital-based study was conducted at Ibrahim Malik Hospital, National Center of Neurological Disease and Sciences from October 2018 to May 2019. A comprehensive, structural, close-ended questionnaire was used to collect data on demographics, clinical, risk factors, treatment, side effects, and outcome. Results: This study covered 32 study participants; the mean age was 33±10 years, with a female predominance of 27 (84%). Nearly, half of them 15 (47%) migraine triggered by weather changes, and 13 (41%) had menstruation. About 17 (53%) was suffering from headache more than 24 months and most of them 26 (81%) used over-the-counter medications for acute pain headache. The mean frequency of attacks per month was reduced from 6.1 baselines to 3.2, in the severity means was 6.9 turns to 5. Reduction in frequency of attacks there was significant in both number and severity (P<0.001) with no significant difference in 50 and 100 mg doses. Concerning adverse effects, 5 (15.6%) did not complain of any, more than a third 12 (38%) experienced weight loss, 7 (22%) both abdominal/gastrointestinal symptoms and dizziness, 5 (16%) mood changes, 4 (13%) both paresthesia and decreased memory, 3 (9%) both anorexia and sleepiness. Conclusion: Topiramate is effective in reducing headache frequency and reasonably well tolerated in adult Sudanese patients with episodic migraine. This may provide good evidence to support its use in routine clinical management.