Antiepileptic medications are taking an increasing role in the prophylaxis of migraine headache. Preliminary observations with topiramate, a broad-spectrum anticonvulsant, suggest it may provide benefit in prevention of episodic migraine. Patients were titrated over 6 weeks by 25-mg. The most common adverse events in the topiramate group were paresthesia, diarrhea, altered taste, and somnolence. These results suggest that topiramate has efficacy in the prophylaxis of migraine headache.
Further study is warranted in larger, placebo-controlled, multicenter trials.