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Review
. 2021 Oct;11(10):e2290.
doi: 10.1002/brb3.2290. Epub 2021 Sep 2.

Advances in topiramate as prophylactic treatment for migraine

Chuan Hu  1 , Yixin Zhang  1 , Ge Tan  1
Affiliations
Review

Advances in topiramate as prophylactic treatment for migraine

Chuan Hu et al. Brain Behav. 2021 Oct.

Abstract

It is well-known that topiramate as a kind of antiepileptic drug has been proved effective for migraine prevention in North America and Europe. However, topiramate is still viewed as an off-label medication for migraine treatment in China, partly because of the limited evidence in Chinese patients. We summarize the effects of topiramate on the frequency, severity, quality-of-life, and adverse event among migraine patients, including children and adolescent in this review, so as to provide reference for Chinese doctors.

Keywords: migraine; prophylactic treatment; topiramate.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Proposed mechanisms of TPM on migraine prevention. In the preclinical model of seizure, TPM blocks Na+ and Ca2+ channels (a) on hippocampal, spinal cord neurons and dentate granule cells, then inhibition the release of glutamate via pre‐synaptic mechanism. Besides that, TPM has negative effect on AMPA (a), and positive effect on GABAa receptor (b) to reduce excessive neuronal discharge. In the rat model of migraine and medication overuse headache, TPM reduces the CGRP release (c) via blocking Ca2+ channels in trigeminal nerve engdings to prevent the development of CSD and headache.TPM = topiramate; AMPA = aminomethylphosphonic acid; GABAa = gamma‐aminobutyric acid A; CGRP = calcitonin generelated peptide; CSD = cortical spreading depression
FIGURE 2
FIGURE 2
Migraine disability assessment responder analysis, percent of responders
See this image and copyright information in PMC

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