Abstract Details

Title Does Lamotrigine Work for Migraine-Associated Vertigo Better than Topiramate?

Topic General Neurology

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-055

Objective The goal of this study is to assess whether lamotrigine reduces migraines and vertigo in patients who were previously on topiramate for treatment of migraine.

Background Approximately 30% to 50% of migraine patients complain of vertigo. Migraine-associated vertigo (MAV) is characterized by vertigo, photophobia, and photosensitivity, and may be accompanied with nausea, vomiting, and headaches in patients with migraine or a history of migraine. Clinical observation has suggested that MAV patients treated with topiramate for migraine who still had complaints of vertigo experienced a reduction of both symptoms after being prescribed lamotrigine. A retrospective chart review was conducted to determine if lamotrigine was a more effective treatment for MAV compared to topiramate.

Design/Methods In this retrospective study, patients who were prescribed both topiramate and lamotrigine from 2010 to 2017 were pulled from the clinic database. To be included in the study, patients had to: meet diagnostic criteria for MAV, been first prescribed topiramate for migraine then lamotrigine for vertigo, and have a follow-up appointment. Start and end dates, dosage, titration levels, migraine and vertigo symptoms were collected before and after starting lamotrigine. Improvement was defined based on patient’s self-reported migraine and vertigo status in their medical records.

Results Thirty-three met the inclusion criteria (M = 47.7 years, SD = 13.5; 26 females). 25 (76%) patients reported an improvement in vertigo. Of the 25 patients, 21 (84%) reported improvement in both migraine and vertigo. The mean and range of dosage for topiramate (M = 41mg, R = 25mg-100mg) and for lamotrigine (M = 136mg, R = 100mg-300mg). Of the 25, 16 (64%) got off topiramate, and 9 (36%) stayed on.

Conclusions Lamotrigine seems to work better for MAV and migraine in patients who were on topiramate for their migraine, but still experienced vertigo. The results suggest lamotrigine may have specific pharmacological effects for MAV.

Authors/Disclosures
Mubasher A. Jaffri PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Jennifer L. Cox, PhD	Dr. Cox has nothing to disclose.
Lixin Zhang, MD, PhD (Dent Neurologic Institute)	Dr. Zhang has nothing to disclose.

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