topiramate and Tension-Type-Headache

Headaches are a common source of pain and suffering. The study's purpose was to assess beta-blockers efficacy in preventing migraine and tension-type headache.. Cochrane Register of Controlled Trials; MEDLINE; EMBASE; ISI Web of Science, clinical trial registries, CNKI, Wanfang and CQVIP were searched through 21 August 2018, for randomized trials in which at least one comparison was a beta-blocker for the prevention of migraine or tension-type headache in adults. The primary outcome, headache frequency per month, was extracted in duplicate and pooled using random effects models.. This study included 108 randomized controlled trials, 50 placebo-controlled and 58 comparative effectiveness trials. Compared to placebo, propranolol reduced episodic migraine headaches by 1.5 headaches/month at 8 weeks (95% CI: -2.3 to -0.65) and was more likely to reduce headaches by 50% (RR: 1.4, 95% CI: 1.1-1.7). Trial Sequential Analysis (TSA) found that these outcomes were unlikely to be due to a Type I error. A network analysis suggested that beta-blocker's benefit for episodic migraines may be a class effect. Trials comparing beta-blockers to other interventions were largely single, underpowered trials. Propranolol was comparable to other medications known to be effective including flunarizine, topiramate and valproate. For chronic migraine, propranolol was more likely to reduce headaches by at least 50% (RR: 2.0, 95% CI: 1.0-4.3). There was only one trial of beta-blockers for tension-type headache.. There is high quality evidence that propranolol is better than placebo for episodic migraine headache. Other comparisons were underpowered, rated as low-quality based on only including single trials, making definitive conclusions about comparative effectiveness impossible. There were few trials examining beta-blocker effectiveness for chronic migraine or tension-type headache though there was limited evidence of benefit.. Prospero (ID: CRD42017050335).

Topics: Adrenergic beta-Antagonists; Adult; Clinical Trials as Topic; Female; Humans; Male; Migraine Disorders; Propranolol; Tension-Type Headache; Topiramate; Valproic Acid

AIM. To analyse the effectiveness of therapeutic exercise on migraines and tension-type headaches (TTH). MATERIALS AND METHODS. Electronic databases were used to search the literature for relevant articles. Eligibility criteria were: controlled randomised clinical trials (RCT), conducted on patients with migraine or TTH, in which the therapeutic intervention was based on therapeutic exercise, and the papers had been published in English and Spanish. Two independent reviewers performed the analysis of the methodological quality using the Delphi scale. RESULTS. Ten RCT were selected, seven of which offered good methodological quality. According to all the studies analysed, the intensity and frequency of pain diminished in comparison to the situation prior to establishing therapeutic exercise, and in five studies the effect was higher than in the control group. The qualitative analysis showed strong evidence of the absence of adverse events following the application of therapeutic exercise. Furthermore, strong evidence was also found of the effect of physiotherapeutic treatment, including therapeutic exercise, in lowering the intensity, frequency and duration of pain in patients with TTH. Limited evidence was also found of the effectiveness of aerobic exercise in patients with migraine, although it was not better than the effects derived from other forms of treatment. CONCLUSIONS. Results show that therapeutic exercise is a safe treatment that provides beneficial effects on migraines or TTH. Further RCT are required in the future with appropriate methodological designs to confirm these results.. Ejercicio terapeutico como tratamiento de las migrañas y cefaleas tensionales: revision sistematica de ensayos clinicos aleatorizados.. Objetivo. Analizar la efectividad que tiene el ejercicio terapeutico sobre las migrañas y las cefaleas de tipo tensional (CTT). Materiales y metodos. La busqueda de articulos se realizo utilizando bases de datos electronicas. Los criterios de inclusion fueron: estudios clinicos aleatorizados (ECA) controlados, realizados en pacientes con migrañas o CTT, donde la intervencion terapeutica se basara en ejercicio terapeutico y publicados en ingles y español. Dos revisores independientes realizaron el analisis de la calidad metodologica utilizando la escala Delphi. Resultados. Se seleccionaron 10 ECA, de los cuales siete presentaron una calidad metodologica buena. Segun todos los estudios analizados, el ejercicio terapeutico disminuyo la intensidad y frecuencia del dolor comparado con la situacion previa, y en cinco estudios el efecto fue mayor que en la comparativa con el grupo control. El analisis cualitativo muestra evidencia fuerte acerca de la ausencia de eventos adversos tras la aplicacion de ejercicio terapeutico. Ademas, se encontro evidencia fuerte acerca del efecto del tratamiento de fisioterapia, incluyendo el ejercicio terapeutico, para disminuir la intensidad, la frecuencia y la duracion del dolor en pacientes con CTT. Se observo evidencia limitada acerca de la efectividad del ejercicio aerobico sobre los pacientes con migraña sin ser superior el efecto al de otros tratamientos. Conclusiones. Los resultados muestran que el ejercicio terapeutico es un tratamiento seguro, que presenta efectos beneficiosos sobre las migrañas o las CTT. Es necesario que futuros ECA con diseños metodologicos adecuados confirmen estos resultados.

Topics: Acupuncture Therapy; Adult; Analgesics; Combined Modality Therapy; Evidence-Based Medicine; Exercise Movement Techniques; Female; Fructose; Humans; Male; Migraine Disorders; Neck Muscles; Pain Management; Physical Therapy Modalities; Randomized Controlled Trials as Topic; Relaxation Therapy; Research Design; Tension-Type Headache; Topiramate; Treatment Outcome

The aim of this study was to assess the efficacy of topiramate in the prevention of tension type headache. Tension type headache is the most common primary headache; the 1-year prevalence is 38%. Tension type headache often causes reduced quality of life.. In this study 51 patients were included; the dose of topiramate was gradually increased to 100 mg and patients were followed up for 6 months. The number of days and decrease in headache intensity were measured by the Visual Analog Scale (VAS) from 1 to 10 before and with therapy.. Study results showed a statistically significant decrease in the number of days with headache: the mean number of days before therapy was 13.25 and with therapy 8.65, (p=0,0001). A statistically significant decrease in headache intensity was also observed by VAS scale: before therapy 6.27 and with therapy 3.33 (p=0.0001).. This study showed topiramate to be efficient in the prevention of tension type headache.

Topics: Adult; Aged; Aged, 80 and over; Anticonvulsants; Female; Fructose; Humans; Male; Middle Aged; Pain Measurement; Quality of Life; Tension-Type Headache; Topiramate

This open study evaluates the effectiveness and safety of topiramate for the prophylaxis of chronic tension-type headache. Fifty-one patients were enrolled, of whom 46 completed 24 weeks of treatment with topiramate. Daily dosing was titrated from 25 mg to 100 mg by treatment week 4. The primary efficacy parameter was headache frequency at weeks 13-24 compared with baseline. Headache frequency declined from 23.50 +/- 5.32 days (baseline, mean, SD) to 12.58 +/- 6.28 days at weeks 13-24 (P < 0.0001), with frequency of severe headaches dropping from 8.18 to 3.14 days (P < 0.0001). The average headache intensity dropped from 6.13 to 2.07 on the visual analogue scale (P < 0.0001). These parameters were not significantly reduced at weeks 5-12. A 50% reduction in headache frequency was achieved in 73% of patients at weeks 13-24. Also improved were mood, sleep, quality of life (all parameters, P < 0.0001) as well as the Beck Depression Inventory-II (P < 0.0001). In addition, a highly significant weight loss of 2.14 kg (mean) was observed between baseline (71.64 +/- 10.65 kg) and week 24 [69.50 +/- 10.04 kg (SD)] (P < 0.0001). There were only few side-effects, none of these rated severe. The results provide preliminary confirmation of the efficacy and tolerability of topiramate in the prophylaxis of chronic tension-type headache.

Topics: Adolescent; Adult; Affect; Analgesics; Anticonvulsants; Chronic Disease; Depression; Female; Fructose; Humans; Male; Medical Records; Middle Aged; Pilot Projects; Prospective Studies; Quality of Life; Sleep; Tension-Type Headache; Topiramate; Treatment Outcome

The surgical treatment of migraine headache is a recent innovation that has broadened the potential patient population who may benefit from craniofacial surgical techniques to millions of affected adults. However, the population at risk in the pediatric age group has not been clearly established. The present retrospective review was performed to provide demographic information of the adolescent migraine in a major children's hospital. This information is essential before considering surgical treatment of migraine in this age group.. Five hundred eighty-eight charts of patients aged 12 to 18 years who presented to the pediatric neurology clinic with headache in 2006 were retrospectively reviewed to evaluate for the diagnosis of migraine. Data collected included headache location, frequency, duration, intensity, associated migraine symptoms, and headache precipitants, as well as the response to medical treatment.. Two hundred ten (36%) of 588 patients had the diagnosis of migraine headache, and 51 patients (24%) were considered refractory to the medical treatment offered. In 101 of the 210 migraine patients, anatomic location of the headaches could be identified. Thirty-nine children (19%) with refractory migraines (mean age, 14.7 years [SD, 0.3 years]) reported definitive migraine triggers.. A significant percentage of pediatric patients with migraine headache remain refractory to medical treatment. At present, there is no good treatment regimen for migraine headaches in the pediatric population. We believe that surgical treatment of migraine headaches may be a realistic option for these patients.

Topics: Adolescent; Amitriptyline; Analgesics, Non-Narcotic; Biofeedback, Psychology; Child; Female; Follow-Up Studies; Fructose; Humans; Male; Migraine Disorders; Neuroprotective Agents; Recurrence; Retrospective Studies; Tension-Type Headache; Time Factors; Topiramate; Vasodilator Agents; Verapamil

Topics: Adrenergic Uptake Inhibitors; Amitriptyline; Anti-Anxiety Agents; Anticonvulsants; Anxiety; Bromazepam; Cyclohexanols; Fructose; Humans; Male; Middle Aged; Selective Serotonin Reuptake Inhibitors; Tension-Type Headache; Topiramate; Venlafaxine Hydrochloride; Vision Disorders