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Academia Mexicana de Neurología, A.C.

2010, Número 5

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Rev Mex Neuroci 2010; 11 (5)


Topiramate vs. Amitriptyline in prophylactic treatment of migraine: A controlled clinical trial

Rodríguez-Leyva I, Sánchez-Aguilar M, Hernández-Sierra JF, Mandeville PB, Rodríguez LMR, Shiguetomi-Medina JM, Tapia-Pérez JH

Idioma: Español
Referencias bibliográficas: 69
Paginas: 338-342
Archivo PDF: 40.08 Kb.


RESUMEN

Background: Migraine-related headache is a frequent problem in medical practice. Its treatment begins by identifying and avoiding triggering agents. The next step is acute headache management and the third step is choosing the best prophylactic treatment for each patient. Objective: To compare the efficacy and cost of Topiramate vs. Amytriptiline as prophylactic treatment for migraine. Materials and Methods: Randomized clinical trial comparing the frequency and severity of migranous headache between Topirmate vs. Amitryptiline as measured by the Migraine Disability Assessment (MIDAS). These measurements were taken before and after the prophylactic treatment in both groups for 4 months. Their adverse effects were also compared as well as each group response to Ketorolac for acute headache management. Results: Thirty six patients were included in the study, eighteen patients in each group. We found a statistically significant reduction of the frequency and intensity of the migranous pain in both groups (p‹0.007), without any significant difference between them. The number of side effects was greater for the Topiramate group (69) than for the Amitriptyline group (43) (p ‹0.001). The Amtriptilyne group showed weight gain while the Topiramate group showed weight loss being this their main side effect. Conclusion: Topiramate and Amitriptyline are both effective prophylactic treatments for migraine. Drug election must be made according to the patient´s characteristics and economic possibilities.


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