Quetiapine for the prevention of migraine refractory to the combination of atenolol + nortriptyline + flunarizine: an open pilot study.

Abstract:

BACKGROUND:Migraine is a prevalent neurological disorder. Although prevention is the mainstream treatment, some patients are refractory to standard therapies. AIM:To evaluate the use of quetiapine (QTP) in the preventive treatment of refractory migraine, defined as previous unresponsiveness to the combination atenolol + nortriptyline + flunarizine. METHOD:Thirty-four consecutive patients (30 women and 4 men) with migraine (ICHD-II) and headache attacks on less than 15 days per month not overusing symptomatic medications were studied. The main inclusion criterion was the lack of response (<50% reduction in attack frequency) after ten weeks to the combination of atenolol (60 mg/day) + nortriptyline (25 mg/day) + flunarizine (3 mg/day). The patients started on QTP as the sole treatment in a single daily dose of 25 mg, titrated to 75 mg. After ten weeks, headache frequency, consumption of rescue medications and adverse events were analyzed. RESULTS:Twenty nine patients completed the study. Among completers, 22 (75.9%; 64.7% of the intention-to-treat population) presented >50% headache reduction. The mean frequency of migraine days decreased from 10.2 to 6.2 and the average consumption of rescue medications decreased from 2.3 to 1.2 days/week. Adverse events were reported by 9 (31%) patients. CONCLUSION:Although limited by the open design, this study provides a pilot data to support the use of quetiapine in preventive treatment of refractory migraine.

journal_name

Arq Neuropsiquiatr

authors

Krymchantowski AV,Jevoux C

doi

10.1590/s0004-282x2008000500002

subject

Has Abstract

pub_date

2008-09-01 00:00:00

pages

615-8

issue

3B

eissn

0004-282X

issn

1678-4227

pii

S0004-282X2008000500002

journal_volume

66

pub_type

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