NEW YORK (MedscapeWire) Apr 19 In the results of a small open-label study reported at the 54th annual meeting of the American Academy of Neurology in Denver, Colorado, quetiapine safely and effectively reduced migraine severity and frequency in patients with severe migraine refractory to standard prophylactic therapy. The atypical antipsychotic acts as an antagonist of serotonin 5HT1a and 5HT2, dopamine D1 and D2, histamine H1, and adrenergic alpha1 and alpha2 receptors.
"Its side-effect profile is particularly appealing as, unlike older, more traditional neuroleptics, quetiapine has a less than 1% incidence of extrapyramidal symptoms and has no statistically significant effects on QT interval versus placebo," write Jan L. Brandes, from Nashville, Tennessee, and colleagues.
In this 3-month study, 11 men and 13 women with migraine meeting IHS criteria and refractory to other prophylactic therapy began adjunctive therapy with quetiapine at a dose of 25 mg daily, titrated to a maximum of 150 mg daily. The average dose of quetiapine was 75 mg daily.
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