与使用偏头痛预防性药物相关的体重变化。

Weight change associated with the use of migraine-preventive medications.

作者信息

Taylor Frederick R

机构信息

Park Nicollet Headache Clinic & Research Center and the University of Minnesota School of Medicine, Minneapolis, Minnesota 55426, USA.

出版信息

Clin Ther. 2008 Jun;30(6):1069-80. doi: 10.1016/j.clinthera.2008.06.005.

DOI:10.1016/j.clinthera.2008.06.005

PMID:18640463

Abstract

BACKGROUND

Medications administered long term, such as those used for migraine prophylaxis, are often associated with weight change as a side effect. Such effects may compromise general health status, exacerbate coexisting medical conditions, and affect medication adherence. Weight gain should be of particular concern in patients with migraine, as there is evidence that overweight and obese patients with migraine are at risk for an increased frequency and severity of migraine attacks.

OBJECTIVE

This article reviews weight-change data from recent clinical studies of migraine-preventive medications in children, adolescents, and adults with migraine.

METHODS

A PubMed search was conducted for English-language articles published between January 1970 and November 2007. Among the search terms were migraine prevention, migraine prophylaxis, migraine treatment, antidepressant drug, beta-adrenergic-receptor blockers, antiepileptic drug, anticonvulsant drug, weight gain, and weight loss. Studies that reported weight-change data (gain, loss, or neutral) were included. When available, double-blind, placebo-controlled studies were selected for review. Open-label, retrospective or prospective trials may also have been included.

RESULTS

Most of the migraine-preventive medications classified by the United States Headache Consortium as group 1 based on the high level of evidence for their efficacy--for instance, amitriptyline, propranolol, and divalproex sodium-have been associated with varying degrees of weight gain. The exceptions are timolol, which is weight neutral, and topiramate, which is associated with weight loss. Among the drugs that have been associated with weight gain, a higher incidence of weight gain was observed with amitriptyline and divalproex sodium than with propranolol.

CONCLUSION

Weight-change effects require careful consideration when selecting migraine-preventive medications, and weight should be monitored carefully over the course of any migraine treatment plan.

摘要

背景

长期服用的药物，如用于偏头痛预防的药物，常常伴有体重变化这一副作用。此类影响可能损害总体健康状况，加重并存的内科疾病，并影响药物依从性。体重增加在偏头痛患者中应特别引起关注，因为有证据表明，超重和肥胖的偏头痛患者发作频率增加、发作严重程度加剧的风险更高。

目的

本文回顾了近期针对儿童、青少年和成年偏头痛患者的偏头痛预防性药物临床研究中的体重变化数据。

方法

在PubMed上检索1970年1月至2007年11月发表的英文文章。检索词包括偏头痛预防、偏头痛 prophylaxis、偏头痛治疗、抗抑郁药、β肾上腺素能受体阻滞剂、抗癫痫药、抗惊厥药、体重增加和体重减轻。纳入报告了体重变化数据（增加、减少或无变化）的研究。如有可能，选择双盲、安慰剂对照研究进行综述。开放标签、回顾性或前瞻性试验也可能被纳入。