PHILADELPHIA — Lacosamide, an anti-epileptic drug that inhibits phosphorylation of collapsing response mediator protein 2 and blocks the release of calcitonin gene-related peptide in the trigeminal system, may be effective in the treatment of chronic migraine, according to study results presented at the 61st Annual Meeting of the American Headache Society, held July 11 to 14, 2019, in Philadelphia, Pennsylvania.
Previous animal studies have reported that lacosamide can be effective in acute migraine therapy, but limited clinical data are available.
This retrospective chart review study included 8 patients (mean age 35.13 years, 5 women) with chronic migraine according to ICHD3-beta criteria who were treated with lacosamide between January 2012 to October 2018 at the University of Utah Headache clinic. All participants had been treated for ≥28 days at the time of their posttreatment Migraine Disability Assessment Score (MIDAS) assessment.
Participants used various medications previously, including triptans, other anticonvulsants (gabapentin, topiramate, valproic acid), NSAIDs, opioid analgesics (hydrocodone, meperidine), beta-blockers (propranolol, nadolol), SSRIs and tricyclic antidepressants (venlafaxine, amitriptyline/nortriptyline, trazodone, duloxetine, sertraline), antihypertensive drugs (verapamil, amlodipine), antipsychotics (prochlorperazine), muscle relaxants and sedatives, and ergotamines.
Treatment with lacosamide (average dose of 100 mg, twice daily) was associated with a mean reduction of MIDAS scores by 43.5 days, reduction of headache frequency by 7.38 days and pain reduction by 1.13 days following treatment initiation.
“We report that lacosamide may be an effective therapy for patients with chronic migraine. Further studies are needed to determine the magnitude of the effect,” concluded the researchers.
Yuan H, Wong K, Davis R, Ozudogru S, Digre K. The effect of lacosamide on chronic migraine: retrospective analysis in a single center academic headache center. Presented at: 2019 American Headache Society Annual Meeting; July 11-14, 2019; Philadelphia, PA.