Safety of topiramate for treating migraines. (September 2014)

• Record Type: Journal Article
• Authors: Marmura, Michael J
• Is Part Of: Expert opinion on drug safety. Volume 13:Number 9(2014)
• Page Start: 1241
• Page End: 1247
• Publication Date: 2014-09
• Subjects: Drugs -- Side effects -- Periodicals; Drugs -- Toxicology -- Periodicals; Chemotherapy -- Periodicals; 615.704
• DOI: 10.1517/14740338.2014.934669
• Languages: English
• ISSNs: 1474-0338

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <p> <bold> <italic>Introduction:</italic> </bold> Migraine is a very common medical disorder characterized by attacks of moderate-severe headache, nausea and disability. <ext-link ext-link-type="uri" xlink:href="http://informahealthcare.com/action/doSearch?type=advanced&displaySummary=true&displaySummary=true&field1=keywords&text1=Topiramate&logicalOpe1=OR&field2=articletitle&text2=Topiramate&logicalOpe2=AND&field3=all&text3=&search=Search&categoryId=41010274&categoryId=40002416&categoryId=40004717&categoryId=40004717&filter=multiple&AfterMonth=1&AfterYear=&BeforeMonth=12&BeforeYear=&sortBy=date&nh=20" xlink:type="simple" xmlns:xlink="http://www.w3.org/1999/xlink">Topiramate</ext-link> is an effective, popular prophylactic migraine treatment, which is approved for use in adults and adolescents. Due to its multiple mechanisms of action, topiramate has multiple potential safety issues, including systemic and CNS adverse events, which may complicate therapy.</p> <p> <bold> <italic>Areas covered:</italic> </bold> This review evaluates common adverse events as seen in the pivotal trials of topiramate for migraine as well as those observed in postmarketing studies. These include weight loss, metabolic acidosis, renal calculi, acute angle closure glaucoma, visual distortions and cognitive slowing. Topiramate use during pregnancy is associated with an increased risk of cleft lip. This review highlights both common and unusual safety issues associated with topiramate use, including important drug interactions and a comparison with other migraine prophylactic agents.</p> <p> <bold> <italic>Expert opinion:</italic> </bold> Topiramate is highly effective in migraine prophylaxis but clinicians using the drug need to be aware of the potential for bothersome or serious adverse events. When treating with topiramate, use a slow titration to the goal dose of 100 mg or the lowest dose, which helps prevent migraine.</p> </abstract>