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Topiramate in the treatment of cluster headache

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Abstract

Cluster headache is a well-characterized, strictly unilateral headache with cranial autonomic features and can be classified as episodic or chronic. Cluster attacks reliably are short-lived, often have a clockwise regularity, and can occur daily for weeks or months during an active cluster period. Pharmacologic treatment for this disorder can be divided into abortive and prophylactic agents. Prophylactic agents aim to quickly induce and maintain a remission. Short-term prophylaxis may be attained with the use of steroids, ergotamine, or methysergide, but these agents are not as suitable for continuous use. Verapamil and lithium commonly are used for longer periods and other agents, such as melatonin and baclofen, also are considered useful. There has been increased interest in the use of anticonvulsants for pain syndromes such as primary headache disorders. This includes topiramate use for cluster prophylaxis; a number of open-label studies have had encouraging results. This article provides an overview of topiramate and the open-label studies of this agent in the prevention of cluster headache.

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References and Recommended Reading

  1. Matharu MS, Goadsby PJ: Trigeminal autonomic cephalgias. J Neurol Neurosurg Psychiatry 2002, 72(suppl ll):19–26. This is a concise review of this group of disorders.

    Google Scholar 

  2. D’Alessandro R, Gamberini G, Benassi G, et al.: Cluster headache in the Republic of San Marino. Cephalalgia 1986, 6:159–162.

    Article  PubMed  CAS  Google Scholar 

  3. Friedman AP, Mikropoulos HE: Cluster headache. Neurology 1958, 8:653–663.

    PubMed  CAS  Google Scholar 

  4. Symonds SC: A particular variety of headache. Brain 1956, 79:217.

    Article  PubMed  CAS  Google Scholar 

  5. Kudrow L: Cluster Headache: Mechanisms and Management. New York: Oxford University Press; 1980.

    Google Scholar 

  6. Ekbom K: Lithium for cluster headache: review of literature and preliminary results of long-term treatment. Headache 1981, 21:132–139.

    Article  PubMed  CAS  Google Scholar 

  7. Gabai IJ, Spierings ELH: Prophylactic treatment of cluster headache with verapamil. Headache 1989, 29:167–168.

    Article  PubMed  CAS  Google Scholar 

  8. Kudrow L: Cluster headache: diagnosis, management, and treatment. In Wolff’s Headache and Other Head Pain, edn 6. Edited by Dalessio DJ, Silberstein SD. Oxford: Oxford University Press; 1993:171–197.

    Google Scholar 

  9. Leone M, Damico D, Moschiano F, et al.: Melatonin versus placebo in the prophylaxis of cluster headache: a double blind pilot study with parallel groups. Cephalalgia 1996, 16:494–496.

    Article  PubMed  CAS  Google Scholar 

  10. Loder E: Naratriptan in the prophylaxis of cluster headache. Headache 2002, 42:56–57.

    Article  PubMed  Google Scholar 

  11. Herring-Hanit R, Gadoth N: The use of baclofen in cluster headache. Curr Pain Headache Rep 2001, 5:79–82.

    Google Scholar 

  12. Marks DR, Rapoport A, Padla D: A double-blind, placebo-controlled trial of intranasal capsaicin for cluster headache. Cephalalgia 1993, 13:114–116.

    Article  PubMed  CAS  Google Scholar 

  13. Hering R, Kuritzky A: Sodium valproate in the treatment of cluster headache: an open clinical trial. Cephalalgia 1989, 9:195–198.

    Article  PubMed  CAS  Google Scholar 

  14. Wheeler S, Carrazana EJ: Topiramate-treated cluster headache. Neurology 1999, 53:234–236. This is a small, but interesting study.

    PubMed  CAS  Google Scholar 

  15. Wheeler SD, Carrazana EJ: Cluster headache responds to topiramate. Presented at the 18th Annual Meeting of the American Pain Society; Fort Lauderdale.October 21–24, 1999.

  16. Wheeler SD, Carrazana EJ: Topiramate-responsive cluster headache (Poster). Cephalalgia 2000, 20:160. A follow-up to the article by Wheeler and Carrazana [14].

    Google Scholar 

  17. Lainez MJ, Pascual J, Santonja JM, et al.: Topiramate in the prophylactic treatment of cluster headache. Cephalgia 2001, 21:369. Abstract and Poster presented at the 10th Congress of the International Headache Society, New York. Abstract P3-R20. June 29–July 2, 2001. Largest group of patients looking at topiramate and cluster headache.

  18. Forderreuther S, Mayer M, Straube A: Treatment of cluster headache with topiramate: effects and side effects in five patients. Cephalalgia 2002, 22:186–169. A small case series.

    Article  PubMed  CAS  Google Scholar 

  19. Leandri M, Luzzani M, Cruccu G, et al.: Drug-resistant headache responding to gabapentin: a pilot study. Cephalalgia 2001, 21:744–746.

    Article  PubMed  CAS  Google Scholar 

  20. Tay BA, Ngan Kee WD, Chung DC: Gabapentin for the treatment and prophylaxis of cluster headache. Reg Anesth Pain Med 2001, 26:373–375.

    Article  PubMed  CAS  Google Scholar 

  21. Storey JR, Calder CS, Hart DE, et al.: Topiramate in migraine prevention: a double-blind, placebo-controlled study. Headache 2001, 41:968–975.

    Article  PubMed  CAS  Google Scholar 

  22. Glauser TA. Topiramate. In Pediatric Epilepsy, edn 2. Edited by Pellock J. New York: Demos Medical Publishing; 2000: 475–488.

    Google Scholar 

  23. Solaro C, Uccelli MM, Brichetto G, et al.: Topiramate relieves idiopathic and symptomatic trigeminal neuralgia. J Pain Symptom Manage 2001, 21:367–378.

    Article  PubMed  CAS  Google Scholar 

  24. Bajwa ZH, Sami N, Warfield CA, et al.: Topiramate relieves refractory intercostal neuralgia. Neurology 1999, 52:1917.

    PubMed  CAS  Google Scholar 

  25. Canavero S, Bonicalzi V, Paolotti R: Lack of effect of topiramate for central pain. Neurology 2002, 58:831–832.

    PubMed  CAS  Google Scholar 

  26. Zvartau-Hind M, Din MU, Gilani A, et al.: Topiramate relieves refractory trigeminal neuralgia in MS patients. Neurology 2000, 55:1587–1588.

    PubMed  CAS  Google Scholar 

  27. Gilron I, Booher SL, Rowan JS, Max MB: Topiramate in trigeminal neuralgia: a randomized, placebo-controlled, multiple crossover study. Clin Neuropharmacol 2001, 24:109–112.

    Article  PubMed  CAS  Google Scholar 

  28. Glauser T: Topiramate. Epilepsia 1999, 40(suppl 5):S71-S80. Comprehensive review of topiramate.

    Article  PubMed  CAS  Google Scholar 

  29. Zhang X, Velumian AA, Jones OT, et al.: Modulation of highvoltage-activated calcium channels in dentate granule cells by topiramate. Epilepsia 2000, 41(suppl 1):S52-S60.

    Article  PubMed  CAS  Google Scholar 

  30. Doose DR, Walker SA, Gisclon LG, Nayak RK: Single-dose pharmacokinetics and effect of food on the bioavailability of topiramate, a novel antiepileptic drug. J Clin Pharmacol 1996, 36:884–891.

    PubMed  CAS  Google Scholar 

  31. Thompson PJ, Baxendale SA, Duncan JS, Sander JWAS: Effects of topiramate on cognitive function. J Neurol Neurosurg Psychiatry 2000, 69:636–641.

    Article  PubMed  CAS  Google Scholar 

  32. York DA, Singer L, Thomas S, Bray GA: Effect of topiramate on body weight and body composition of Osborne-Mendel rats fed a high-fat diet: alterations in hormones, neuropeptide, and uncoupling-protein mRNAs. Nutrition 2000, 16:967–975.

    Article  PubMed  CAS  Google Scholar 

  33. Manzoni GC: Gender ratio of cluster headache over the years: a possible role of changes in lifestyle. Cephalalgia 1998, 18:138–142.

    Article  PubMed  CAS  Google Scholar 

  34. Bahra A, May A, Goadsby PJ: Cluster headache: a prospective clinical study in 230 patients with diagnostic implications. Neurology 2002, 58:354–361.

    PubMed  Google Scholar 

  35. Petroff OAC, Hyder F, Mattson RH, et al.: Topiramate increases brain GABA, homocarnosine, and pyrrolidinone in patients with epilepsy. Neurology 1999, 52:473–478.

    PubMed  CAS  Google Scholar 

  36. Loscher W: Valproate: a reappraisal of its pharmacodynamic properties and mechanisms of action. Prog Neurobiol 1999, 58:31–59.

    Article  PubMed  CAS  Google Scholar 

  37. May A, Bahra A, Buchel C, et al.: Hypothalamic activation in cluster headache attacks. Lancet 1998, 351:275–278.

    Article  Google Scholar 

  38. Weiller C, May A, Limmroth V, et al.: Brain stem activation in spontaneous human migraine attacks. Nature Med 1995, 1:658–660.

    Article  PubMed  CAS  Google Scholar 

  39. May A, Kaube H, Bechel C, et al.: Experimental cranial pain elicited by capcaicin: a PET-study. Pain 1998, 74:61–66.

    Article  PubMed  CAS  Google Scholar 

  40. Moore K: Cluster headache: the challenge of clinical trials. Curr Pain Headache Rep 2002, 6:52–56.

    Article  PubMed  Google Scholar 

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McGeeney, B.E. Topiramate in the treatment of cluster headache. Current Science Inc 7, 135–138 (2003). https://doi.org/10.1007/s11916-003-0023-3

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  • DOI: https://doi.org/10.1007/s11916-003-0023-3

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