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| This news site is not sanctioned by, nor part of, the Diamond Headache Foundation, The American Academy of Neurology OR The American Headache Society. |
| News covering selected sessions related to migraine from 2008 medical conferences. |
| Diamond Headache Clinic Research and Educational Foundation Annual Research Summit |
Scottsdale, Arizona February 18-22, 2008 |
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Gender-Based Issues in Epilepsy
Management |
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BY MAURY BREECHER
Contributing Writer |
SCOTTSDALE, ARIZ. (ECCC)—
When prescribing epilepsy drugs to prevent or treat migraine,
physicians need to warn their female patients that these drugs
may lessen the efficacy of oral contraceptives, reported Dr.
Susan M. Rubin on February 19 at a headache symposium sponsored
by the Diamond Headache Clinic Research and Education
Foundation.
Some 30% to 50% of women with epilepsy – including those who
experience regular migraine headaches—are likely to have
seizures that correspond to their menstrual cycles, said Dr.
Rubin, director of the Women’s Neurology Center at Evanston
Northwestern Healthcare, Glenville, Ill.
“Their vulnerability to seizures is highest just before and
during flow and at ovulation when their estrogen levels are
relatively high compared to progesterone levels,” she said.
Topiramate, for example, was originally used only to treat
epilepsy, but now is also used for migraine patients. Dr. Rubin
said the dosage prescribed plays a role in its interference with
birth control.
“When we are treating epilepsy, we typically use higher doses,
in the 200 mg ranges, and at those doses topiramate does seem to
lessen the efficacy of oral contraceptives,” she said. “However,
when treating migraines in women without epilepsy, we use much
lower doses and no loss of birth control efficacy has been
reported.”
She added that other epilepsy drugs that may have possible
interactions with oral contraceptives include carbamazepine,
oxcarbazepine, phenobarbital, and phenytoin.
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