Pharmacological mechanism of topiramate in the prophylaxis and treatment of migraine: a review

Authors

  • Emanuela Paz Rosas Universidade Federal de Pernambuco
  • Raisa Ferreira Costa Universidade Federal de Pernambuco
  • Silvania Tavares Paz Universidade Federal de Pernambuco
  • Ana Paula Fernandes da Silva Universidade Federal de Pernambuco
  • Manuela Freitas Lyra de Freitas Universidade Federal de Pernambuco

DOI:

https://doi.org/10.48208/HeadacheMed.2018.21

Keywords:

Topiramate, Migraine disorders, Pharmacology

Abstract

Objective: This review sought to bring evidence of studies addressing the mechanisms of action of topiramate in the prevention and treatment of migraine. Background: Migraine is a neurovascular disorder that affects a large part of the world population. The use of prophylactics contributes to the decrease in the frequency and severity of this disease. Among the antiepileptic drugs, the topiramate, has proven to be the most effective for the treatment of migraine. Although the mechanism of action of this drug is still not well elucidated in the literature, there are several molecular mechanisms proposed. Methodology: A survey was carried out in the literature, from February to March 2018, in different databases, using the descriptors: topiramate, migraine and mechanisms of action. After a careful selection, 25 manuscripts were chosen for this review. Results: Evidence from a number of studies has indicated that the main mechanisms of action of topiramate are related to the modulation of voltage-dependent sodium and calcium ion channels, blockade of excitatory glutamate transmission and inhibition by gamma-aminobutyric acid receptors (GABA), AMPA/kainate and some isoenzymes of carbonic anhydrase. In addition, topiramate is involved in the suppression of cortical spreading depression, besides influencing trigeminovascular activity, and neuronal excitability. Conclusion: Thus, topiramate could be involved in the prevention of major events of the pathophysiology of migraine. Acting directly on cortical spreading depression (DAC), trigeminovascular signals and decreased central sensitization of migraine pain.

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Author Biographies

Emanuela Paz Rosas, Universidade Federal de Pernambuco

Programa de Pós-graduação em Biologia Aplicada à Saúde, Laboratório de Imunopatologia Keizo Asami (LIKA) Universidade Federal de Pernambuco (UFPE), Brasil

Raisa Ferreira Costa, Universidade Federal de Pernambuco

Programa de Pós-graduação em Ciências Biológicas, UFPE, Brasil

Silvania Tavares Paz, Universidade Federal de Pernambuco

Programa de Pós-graduação em Saúde Translacional, UFPE, Brasil 

Ana Paula Fernandes da Silva, Universidade Federal de Pernambuco

Programa de Pós-graduação em Biologia Aplicada à Saúde, Laboratório de Imunopatologia Keizo Asami (LIKA) Universidade Federal de Pernambuco (UFPE), Brasil

Manuela Freitas Lyra de Freitas, Universidade Federal de Pernambuco

Departamento de Anatomia, UFPE, Brasil

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Published

2018-12-31

How to Cite

1.
Rosas EP, Costa RF, Paz ST, Silva APF da, Freitas MFL de. Pharmacological mechanism of topiramate in the prophylaxis and treatment of migraine: a review. Headache Med [Internet]. 2018 Dec. 31 [cited 2024 Dec. 13];9(4):190-5. Available from: https://headachemedicine.com.br/index.php/hm/article/view/225

Issue

Section

Review

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