| International Symposium, Topamax Study | |
The theme of the Migraine Trust's biennial International Research Symposium for 2002 is "RESEARCH is the Key," building on the belief that research is the key to the future for people with headache disorders. Professor Peter Goadsby is the Chairman of the Symposium, and is lecturing at the public program portion. He said, "This is a great opportunity, creating the chance for sufferers and researchers to meet and talk about the condition to ensure a fully rounded discussion. We are pleased to invite the public to this conference and look forward to the open forum following the lectures."
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This is the 14th biennial symposium hosted by the Migraine Trust, and is the larges of its kind in the world, attended by leading neurologists, researchers, and health professionals. It is intended to bring to light the latest developments in Migraine research and treatment. Topics covered by the Symposium's lectures in the field of Migraine are pathophysiology, disability, and children.
One of the Symposium presentations has resulted in major international publicity. Dr. Stephen Silberstein, Director of the Jefferson Headache Center, presented the results of a study and his experience using topiramate/Topamax as a preventive Migraine medication.
Dr. Silberstein reported on a Phase III study
involving 469 Migraine sufferers. The participants were given varying doses of
topiramate or placebos. Approximately 50% of the participants showed a 50%
reduction in frequency and duration of their Migraine attacks.
The best results were achieved at a dosage of 100 or 200 milligrams of
topiramate per day, a lower dosage than that used to treat epilepsy. The most
commonly experience side effects were nausea and tingling of the extremities.
Silberstein said, "What was amazing in this trial was the effect on
weight. The patients who got topiramate lost, on average, 3.8 percent of their
body weight." Occurrence and severity of the side effects were shown to have a
correlation to the dosage level. The study is to be the used as part of the
application to the FDA for topiramate to be approved for use as a Migraine
preventive.
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MAGNUM's Executive Director, Mr. Michael John Coleman, spoke briefly with Dr.
Stephen Silberstien in London Monday advising him that the American Congress has
sent official letters supporting the symposium's agenda of improving the quality
of Migraine and pain sufferers worldwide to the Migraine Trust. Coleman spoke
very highly of Dr. Silberstien and referred to him as one of America's top
medical thought leaders in the area of Migraine disease. In addition, Coleman
was thrilled with the high profile of preventive treatment as a key part of
Migraine disease management.
Back in Washington, D.C., Ms. Terri Miller Burchfield informed me that MAGNUM
was gratified to see a multifactorial approach to Migraine health care at the
center of the discussion at the London conference. She went on to point out that
recognizing Migraine disease management should address not just one or two
protocols, but rather is should address all the major areas of therapy; that of
abortive and preventive treatment, as well as trigger and pain management.
Treating Migraine in it's totality, rather than treating just part of it is a
positive step in the right direction in this major
pain public health issue.
"Migraine is due to a more sensitive brain," said Silberstein. Research released in 2000 revealed that Migraineurs have abnormally excitable brain nerve cells (neurons). When a trigger is encountered, these neurons fire across the brain, across pain centers, awakening nerve pain and inflaming blood vessels.
He went on to say, "When migraine episodes start occurring once or more a week, as it does for about one out of every five sufferers, the disability is significant. At that point, it's time -- for the sake of the patient -- to start taking serious steps to prevent the attacks from coming on, rather than rely only on acute treatment when an episode has already begun. But there is only so much a patient can do through lifestyle changes, and few medications have shown efficacy in prevention."
The manufacturer, Ortho-McNeil, reportedly halted clinical trials testing Topamax to treat obesity while it reformulated the drug in February because of its side-effects, including memory problems, fatigue, sleepiness, difficulty in concentration and tingling in the fingers and toes. In early September, testing of topiramate for bipolar disorder because it was not effective enough.
Topiramate/Topamax is a neuroleptic medication in the same
drug class as Depakote and Neurontin, which are also prescribed for Migraine
prevention. Standard protocol with these medications is to start at a low
dosage, tapering up to the target dosage. If a patient discontinues these
medications, that also should be accomplished by tapering, taking it down
gradually, by steps, from the current dosage. This should always be accomplished
with the assistance of a physician.
- The Migraine Trust, Press Release.
- Doctor's Guide Channels, "New Study Shows Topamax (Topiramate) Can Reduce Frequency of Migraine Headaches."
- CBSNEWS.com, "Migraine Relief From Unexpected Source."
- MSNBC.com, "Epilepsy drug may help migraines."
- Telephone interview conducted by Teri Robert with Mr. Coleman from the International Research Symposium on September 24, 2002.
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