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IHS: Lamotrigine Effective in Migraine Prophylaxis By Jill Stein Special to DG News NEW YORK, NY -- July 2, 2001 -- New findings document the potential efficacy of lamotrigine for migraine prophylaxis. The results were presented at the 10th Congress of the International Headache Society (IHS) by Dr. Steve D. Wheeler, with the Neurologic Center of South Florida in Miami, Florida. In the trial, 65 patients with migraine or chronic daily headache were prescribed lamotrigine on a compassionate use basis for preventive therapy during a recent ten-month period. The primary study endpoint was a decrease in severe headache frequency of at least 50 percent. Secondary endpoints included a decrease of at least 50 percent in mild and moderate headache frequency or aura frequency. Efficacy was assessed at three months in 30 evaluable patients and at two months in five evaluable patients. Overall, 24 patients had transformed or chronic migraine, seven had episodic migraine, and four had hemicrania continua. The mean lamotrigine dose was 55.1 mg/d. Treatment was adjunctive in 34 patients. Seventeen (48.6 percent) patients had a significant improvement, with a reduction in severe headache frequency of at least 50 percent. Of 18 patients with aura, 12 (66.7 percent) had a reduction in headache frequency of at least 50 percent. Of nine analgesic rebound or overuse patients, only one improved significantly. Significant improvement was noted in two (28.6 percent) of seven non-rebounding chronic migraine patients without aura and four (50 percent) of eight non-rebounding chronic migraine patients with aura. Significant improvement was also observed in three (75 percent) of four patients with hemicrania continua. The results of this open-label trial suggest that lamotrigine is effective for migraine prevention and that effectiveness is improved in migraineurs with aura and diminished in patients with analgesic overuse, Dr. Wheeler said. Benefit was also seen in some intractable populations, including chronic migraine with aura and hemicrania continua. Based on the findings, he recommended that randomized, double-blind, controlled trials be conducted. E-mail this page to a friend or colleague! To print, use this version