A new long-term study into migraine prevention published in The Lancet Neurology shows that patients who continued with Topamax(R) (topiramate) for migraine prophylaxis for up to a year experienced a sustained reduction in the number of migraine days per month, with significant associated benefits on quality of life measures.1 The study also found that there was a significant increase in the number of monthly migraine days following discontinuation of topiramate, however, the number did not return to pre-treatment levels.1

Migraine is a very common disorder affecting around 11% of the adult population in the Western world.2 One UK study estimated that 5.85 million people in the UK, aged 16-65 years, experience 190,000 migraine attacks everyday resulting in the loss of 25 million days from work or school each year.3

The PROMPT (PROlonged Migraine Prevention with Topiramate) study was a 12-month, multicentre, double-blind, randomised, placebo-controlled study conducted to investigate the continued effectiveness of topiramate in reducing the number of migraine days beyond six months, compared with the impact of stopping treatment at six months. All patients received open-label Topamax for the first 6 months, and then were randomised to either continue Topamax or take placebo for the second 6 months in a double-blind design.

After 6 months of open-label topiramate treatment, the mean number of monthly migraine days fell significantly from 8.93 to 5.83, a reduction of 3.1 migraine days per month (p After 6 months of open-label treatment with topiramate, quality of life (measured using the Migraine Disability Assessment Questionnaire, MIDAS) was also significantly improved, with mean MIDAS scores reduced by 21.18 to 15.40 (p 20) to 'moderate disability' (score < 21). At 12 months, quality of life had deteriorated significantly following the switch to placebo, with mean MIDAS scores increasing by 6 points in this group (p