8. Prophylaxis therapy with levetiracetam in elderly migraine patients: An updated open-label study

In the last years, the hypothesis that cortical hyperexcitability may play a role in the physiopatology of migraine led to the therapeutic use of some antiepileptic drugs. To evaluate the efficacy of levetiracetam as prophylactic treatment for migraine without aura in elderly patients. We performed a small open-label trial treating 22 elderly patients (12F 10M) mean age 67.3 years (SD 5.03), range 60-79 years affected by migraine without aura (ICDH ’04 criteria). The mean age of disease was 17.9 years (SD 13.4) range 2-45 years. At baseline: the frequency of attacks was 11.9/month (SD 5.3), range 6-25; the mean number of drugs for acute attacks was 11.9 (SD 5.7) tablets/month. All patients took concomitant medication for other cronic diseases. After recruitment Levetiracetam 500 mg/die was administered for 1 week and 1000 mg/die for six months. The basal frequency of attack was 11,9 (SD 5.3) and 8,2 (SD 4.9), 5,3 (SD 3.9), 2,4 (SD 2.4) after 1, 3 and 6 months Correspondence/Reprint request: Prof. Anna Capasso, Department of Pharmacy, University of Salerno, Italy E-mail: [email protected] Vincenzo Pizza et al. 200 respectively [P=0.021; P<0.0001; P<0.0001]. The basal value of intaking drugs for acute attacks was 11,9 (SD 5.7) and 7,1 (SD 4.8), 3,9 (SD 3.2), 1,9 (SD 2.3) after 1, 3 and six months respectively [P=0.004; P<0.0001; P<0.0001] (T-test analysis). Levetiracetam was well tolerated (10 patients complained somnolence, lack of concentration, vertigo and gastralgia but none patient withdrew the study). In our study levetiracetam showed a good efficacy in frequency and intensity reduction of headache attack and showed a very good tolerability despite all elderly patients took drugs for concomitant diseases.