topiramate

10 November 2014

Abdominal Migraine in Adults

James Discoveries & Stats, Information, Medications, Treatments 0

Abdominal pain – likely a nauseous feeling – recurring again and again. It can be very hard to get a diagnosis, but it could be abdominal migraine.

Abdominal migraine in adults is not often recognized, even though the medical community has been talking about it for almost a hundred years. Abdominal migraine is well recognized in children, all the more reason why it’s overlooked in adults. And to be fair, it probably is a rare condition.

As with most types of migraine, abdominal migraine brings on recurring symptoms. It usually lasts from a couple of hours to three days.

Unlike migraine headache, the pain in the abdomen isn’t one-sided. It could be very severe, or just a dull ache. During an attack, there is usually nausea and/or vomiting, or you may become pale and lose your appetite.

To be technically diagnosed with abdominal migraine, there should be no headache associated with the attack. In other words, instead of headache you have abdominal pain. However, it’s true that other types of migraine may include abdominal pain as well.

Other characteristics of migraine may be present, such as an aura before an attack.

Abdominal migraine usually starts in childhood and disappears in adulthood (or “changes” into other types of migraine). But there have been cases of abdominal pain from migraine appearing in adolescence and early adulthood for the first time.

Diagnosis of Abdominal Migraine in Adults

If the above description sounds like you, you’ve taken the first step. But your doctor will still want to run some tests and rule out other possibilities.

Be sure to tell your doctor how many attacks you’ve had, and what the symptoms were. She’ll want to rule out various other conditions, such as gallstones, irritable bowel syndrome, infections, and even abdominal epilepsy, which can be quite similar.

A common feature of abdominal migraine in adults seems to be a family history of migraine. If you know anyone in your family who may have had migraine, be sure to mention that. Also, your doctor will want to know if you had migraine symptoms when you were younger, or possibly cyclic vomiting syndrome.

Treatment of Adult Abdominal Migraine

Because it is so rarely diagnosed, there’s no standard treatment. However, there are some treatments which have been used successfully.

Triptans, a common migraine abortive, such as sumatriptan, may be tried. Pizotifen (pizotyline, Sandomigran, Sanomigran), a serotonin antagonist, has been used for abdominal migraine in adults. Other migraine treatments such as topiramate (Topamax), calcium channel blockers, beta blockers, and valproic acid (Depakote) may be tried, depending on the patient. Antihistamines have also been used.

For more information:

21 August 2014

Topamax not working? Here’s a Possible Alternative

James Discoveries & Stats, Medications, Treatments 4

Although Topamax (topiramate) has helped many patients, it is by no means the silver bullet to stop migraine. It’s popularity has also been hampered by the side effects that some patients experience.

Of course there are many good alternatives to Topamax, but researchers are looking for something similar that will work for patients that are good candidates for something like topiramate, but who do not respond well to topiramate itself.

A study published in July (2014) investigated a drug called zonisamide as an alternative to topiramate. In this case, patients with episodic migraine with aura were studied. These were not patients who had severe reactions to topiramate, but who simply had not seen more than a 50% reduction of migraine attacks.

Zonisamide (sold as Zonegran)is another antiseizure drug. Like Topamax, side effects are a common reason why patients do not continue with the treatment. In fact, in this study 12% dropped out because of side effects such as dizziness, nausea, insomnia, and drowsiness.

In the end, however, there were two positive results.

First, many of the patients had much better success with zonisamide. Over three months, every month things got better.

Second, side effects did actually seem to be less of a problem with zonisamide. In particular, paresthesia (a tingling or burning feeling of the skin), one of the most common side effects in topiramate, was almost non-existent.

This is only a preliminary study. It was open label (meaning the patients knew what they were taking), and patients directly switched to a steady dose of zonisamide (100mg/day taken in two doses). It will be interesting to see how patients respond to different doses.

One other interesting note – some patients dropped out because they improved very quickly and decided they didn’t need more treatment! That sounds great, although it’s too bad they didn’t understand the value of continuing the study so that the results can be measured.

Zonisamide has not been approved as a migraine medication, but this study shows that it is worth studying as an alternative preventative to Topamax. If you’ve tried it, leave a comment and let us know how it worked for you.

Sources:
Efficacy of Zonisamide in Migraineurs with Nonresponse to Topiramate
Zonegran (Drugs.com)

10 September 2013

Topamax and Hair Loss?

James Resources 20

There’s a lot of discussion going on about hair loss as a side effect of Topamax (topiramate). Because of the time it takes hair to grow back, this can be an issue that goes on even after you’ve stopped taking it.

Although this doesn’t seem to be one of the most common side effects of Topamax, it’s obviously one to be concerned about.

But I’m not going to write about it – because the fine folks over at MigreLief already did some research. 🙂 So I suggest you check out the article I’m linking to below. But I would like to hear from you here – have you experienced this side effect? Did you find any solutions?

Hair loss from Topamax? Recommendations for battling Topirimate side-effects

17 June 2013

Miracle Medication helps 3 in 10 Migraine Sufferers!

James Discoveries & Stats, Medications 8

Yes, there is an amazing medication that helps – 3 in 10 migraineurs! Ok, that doesn’t sound like much. Actually, it isn’t.

It is great for those 3, of course! But for the rest, no so great.

So what is this medication? Actually, it’s not just one medication – it’s most of the common ones you’ve heard of. No, I’m not saying that all medications only help 3 in 10, but that a single medication will probably only help 3 in 10.

This is based on research done at the Minnesota Evidence-based Practice Center. Researchers wanted to pool results from 5,244 clinical trials of migraine medications.

They examined 59 drugs in 14 different drug classes. This would include medications like:

Topamax
Depakote
Inderol
Toprol-xl

…and many more.

The researchers concluded that, generally speaking, individual drugs helped – at least, better than a placebo – about 200-400 people out of 1000.

Of course, whether they helped or not, many medications aren’t continued because of side effects. Some of the worst offenders include topiramate (Topamax), other antiepileptics used off label, and antidepressants.

Some drugs did much better when it came to side effects vs. benefit. These included angiotensin inhibitors (such as lisinopril (ie Zestril)) and beta-blockers (such as metoprolol or propranolol).

Other than the lack of a miracle drug, there were a couple of other things that did not impress the researchers. One was that many trials were of poor quality. Another was that there is a lack in research into the long term effects of these drugs, particularly when it comes to quality of life.

Again, this report is not suggesting that only 3 in 10 migraineurs can be helped with medication. Considering all the various drugs and treatments and combinations, that number is much higher. There is good treatment available!

But once again we’re reminded that migraine is very individual – what helps one person won’t help another.

We’re also reminded that much of the excellent migraine-fighting medication available today is still very new. We don’t have good studies, and we don’t know what the risks are when it comes to taking these meds long term.

A neurologist reflects on these findings: Effective Migraine Prevention per 215 Trials
Also see: Is your migraine preventive treatment balanced between drugs’ benefits and harms?

24 April 2013