NEW YORK (Reuters Health) - The results of a study published in the medical journal Cephalalgia indicate that preventive migraine therapy with nadolol or topiramate significantly improves the quality of life of patients with migraine, although their quality of life still remains below the average level.
Nadolol, sold in the U.S. under the trade name Corgard, is a beta-blocker that is used to treat high blood pressure and angina (chest pain). The drug works by slowing the heart rate and relaxing the blood vessels. Topiramate, sold under the trade name Topamax, is used to treat seizures in patients with epilepsy.
“Preventive medication should not only reduce the frequency of attacks, but should also result in an improvement in the patient’s quality of life,” write Dr. Juan C. Garcia-Monco, of Hospital de Galdacano, Vizcaya, Spain, and his associates.
To investigate this point, the researchers studied 76 consecutive migraine patients at least 16 years of age, evaluating them at the beginning of the study and again after 16 weeks of treatment with nadolol at 40 milligrams per day or topiramate at 100 milligrams per day. The study was completed by 61 of the patients.
Preventive therapy led to significant improvement in the physical domains of the Short Form 36 Health Survey, a standard test used to assess various aspects of patients’ health. Scores on the mental domains, however, remained basically unchanged, and all domains remained below the average of the general population.
The results of the Hospital Anxiety and Depression Scale revealed a mild anxiety state and a moderate depressive state at the beginning of the study, which both remained unchanged after therapy.
The migraine-related quality of life questionnaire score indicated statistically significant improvements with treatment.
“After the overall evaluation of the impact of preventive medication on patients’ quality of life, the impact of each drug separately was assessed by analyzing the therapeutic gain of each drug,” Garcia-Monco and colleagues explain.
No differences between the two drugs were observed for any domain of the questionnaires. The one exception was a better response on the physical domain of the Short Form 36 Health Survey with topiramate compared with nadolol.
The team concludes that despite these improvements, further efforts are needed “to return these patients as close to normality as possible.”
SOURCE: Cephalalgia, August 2007.
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