• Amnon Mosek and Marina Dano.
• Department of Neurology, The Headache and Facial Pain Clinic, Tel Aviv Sourasky Medical Center, 6 Weizmann St., Israel. mosek@tasmc.health.gov.il
• J Headache Pain. 2005 Apr 1; 6 (2): 77-80.

AbstractChronic daily headache (CDH) is a debilitating disorder that becomes a treatment challenge in patients refractory to the treatment. We hereby report our experience with topiramate treatment in patients with refractory CDH. The study design was a prospective, protocol-based follow-up and retrospective analysis of headache diaries. We treated with topiramate at slowly increased moderate increments 11 CDH patients who were refractory to multiple previous treatments. Topiramate treatment was effective in 7 (64%) patients. The treatment resulted in a 66% (median) decrease of the headache days per week and a significant decrease in headache severity, a reduction of the headache hours per day, and weekly analgesic consumption. These effects continued for an average follow-up of 8+/-4 months. The average effective dose was 100 mg/day. Slowly increasing the drug at moderate increments resulted in high tolerability of topiramate. We found topiramate to be an effective long-standing treatment option for patients with refractory CDH. Slow increments of the dosage contributed to high tolerability of the drug.

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