Rising uric acid levels tied to migraine drug

NEW YORK (Reuters Health) - In migraine patients, treatment with the drug topiramate (sold as Topamax) may result in increasing blood levels of uric acid, a study shows.

Some research has linked high uric acid levels in the body to a higher risk of cardiovascular trouble. Excess uric acid in the body can create oxidative stress, a state that damages body cells and contributes to diseases, including the buildup of artery-clogging plaques.

Decreases in body weight and the development of kidney stones have been reported with topiramate use, the investigators explain, but changes in uric acid and lipid levels have not been studied.

Dr. Abdulkadir Kocer from Duzce University, Duzce, Turkey and colleagues measured blood uric acid, cholesterol, and triglyceride levels in 53 patients with migraine who were receiving topiramate, as well as in 44 matched control subjects not treated with this drug.

Average uric acid levels were significantly higher in the migraine patients receiving topiramate than in healthy controls, the investigators report. Average serum triglyceride and total cholesterol levels were also higher in the migraine group, but the differences were not statistically significant.

Among patients for whom pretreatment uric acid levels were known, average uric acid levels were significantly higher after initiation of treatment than in the pretreatment measurements.

"We think that there is a need for careful monitoring of the serum uric acid and lipid profile in patients receiving topiramate," the researchers conclude.

Considering the potential link between abnormally high uric acid levels and cardiovascular complications, "more emphasis should be put on the topiramate-related complications" such as high uric acid levels, they add.

SOURCE: Headache, July/August 2008.