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Lacosamide (Vimpat) for Migraine and Headache

   
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At this time, there are no medications on the market that were developed specifically for Migraine and headache prevention. We use medications that were originally developed for other conditions, then noticed to work for Migraine and headache prevention.

Migraine, headache, and pain management specialist Dr. John Claude Krusz is always looking at medications we can use for Migraine and headache management. At the 52nd annual scientific meeting of the American Headache Society (June, 2010), Dr. Krusz presented a research poster entitled, "Lacosamide in the Treatment of Chronic Headache and Migraine Disorders." The poster was based on research conducted in his practice.

The study:

Study objectives:

"We studied a new anticonvulsant, lacosamide (Vimpat), in the prophylaxis of chronic daily headaches [CDH] and mixed chronic migraine disorders."

Study background:

"Lacosamide is a new anti-convulsant with a unique mechanism of action that enhances the slow inactivation of voltage-gated sodium channels in nerve. Because other sodium channel agents have been shown to have efficacy in the prophylaxis of chronic headache disorders, we chose to study this agent in our clinic population who had failed multiple other medication trials for their headaches."

Study methods:

  • Study participants were 22 patients at the ANODYNE Headache & PainCare Center in Dallas.
  • Participants had tried up to 6-7 other prophylaxis agents that had failed to work for chronic Migraines, CDH and mixed headache disorders with neck/TMD pain.
  • All 22 Patients were treated with daily lacosamide in increasing doses, averaging 10-14 days between dosage changes.
  • Average lacosamide dosage per day was 165 mg.
  • 14 patients (64%) had neck pain or TMD co-existent with Migraines and CDH.

Study results:

  • Average lacosamide treatment was 94 days at the above dosage.
  • The number of headache and Migraine days per month at the beginning of lacosamide treatment was 21.4 (12-30 days per month).
  • After treatment with lacosamide, the average headache and Migraine days per month reduced to 13 per month.
  • Four patients had no response, mainly due to side effects such as nausea, cognitive complaints or drowsiness.
  • Eleven of 14 (79%) patients with co-existent pain also reported a reduction of about 47% of their symptoms.

Study conclusions:

"We conclude that lacosamide may offer a newer approach to prophylaxis of CDH and chronic migraine. It has a novel mechanism of action on sodium channel function in nerve, and should be studied rigorously in a double-blind manner."
 

Summary and comments:

The results of this study are fairly self-explanatory. In this group of 22 patients, 18 saw a reduction in Migraine and CDH after 94 days of treatment with lacosamide. Eleven of the 14 patients with other pain issues also saw a reduction in their symptoms.

Although lacosamide is a neuronal stabilizing agent (anti-convulsant), it's works differently than other medications of this type. Larger, double-blind clinical trials are needed to produce more information about the use of lacosamide for Migraine and headache prevention.

____________
Resources:

Krusz J.C.; Albright J.P. "Lacosamide in the Treatment of Chronic Headache and Migraine Disorders." Poster Presentation. 52nd annual scientific meeting of the American Headache Society. Los Angeles. June, 2010.


Medical review by John Claude Krusz, PhD, MD

  

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Teri Robert, 2010. Last updated August 9, 2010.

 
       

 

 The American Headache and Migraine Association (AHMA)...

a patient-focused, patient-driven organization for patients with Migraine and
other headache disorders and their family, friends, and care partners.
Anyone interested in the concerns or patients with these disorders is welcome to join.

The AHMA exists to EASE the burden of Migraine and other headache disorders through Education, Awareness, Support, and Engagement.

www.ahma.ws


 

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