Poster 103: Small case series of gabitril (tiagabine) for prophylaxis of chronic daily headache with migrainous features.

Abstract

Objective: To investigate whether gabitril (Tiagabine) is effective in the prophylaxis of chronic daily headaches and migraine headaches. Design: Retrospective chart review analyzing the reports of headache before and after the administration of Tiagabine. Setting: Outpatient pain clinic. Participants: 5 patients with chronic daily headache with migrainous features. Intervention: Patients were treated with an initial dose of Tiagabine at 2mg/d for the first week and their dosages were increased by up to 14mg/d. Main Outcome Measures: A visual analog scale (VAS) was used to measure the intensity of the headaches before and after treatment with Tiagabine. The number of days with headaches before and after treatment with Tiagabine were reported. Also, the number of hours with headache before and after treatment were noted. Adverse side effects were also included. Results: Using a paired t test, the pretest VAS mean was 7.7 and the posttest mean was 4.4 on a scale from 0 to 10 ( t 4=2.703, P=.054), with 10 representing the most severe pain. The mean dose of Tiagabine for all patients was 5.1mg/d. The mean number of headache days per month decreased from 21.6/28 days to 11.2/28 days. The mean duration of the headache attack decreased in 2 of the 5 patients. Adverse events were reported by 2 of the 5 patients, which included dizziness during titration, abdominal pain, and easy bruising. Conclusions: Tiagabine may be useful to treat chronic daily headaches with migrainous features. Because of the small number of patients and wide variation in ratings, statistical significance was not obtained. With a larger sample, statistical significance would have been more likely. Further studies are needed with larger sample sizes to clarify the significance of using Tiagabine for the prophylactic treatment of chronic daily headaches.