Trial of Nortriptyline and Topiramate in the Initial Treatment of Vestibular Migraine
Status:
Terminated
Trial end date:
2019-10-30
Target enrollment:
Participant gender:
Summary
The investigators' study plans to randomize treatment naive patients with vestibular migraine
to an 8 week trial of an escalating dose of either nortriptyline or topiramate followed by an
8 week crossover to the other drug if patient is willing, if patient wants to stay on first
medication we will just continue to follow. During the first 8 weeks if there is an
intolerance to the first drug they can be switched to the other drug at any point and then
followed on that medication for the remainder of the study. Response to therapy will be
quantified by the Migraine Specific Quality of Life (MSQ) and Dizziness Handicap Inventory
(DHI) administered at multiple time points during the study. Three groups of patients that
will be eligible for the study will include 1)Patients with Neuhauser dVM; 2)Patients with
pVM; and 3) Patients with dizziness that falls outside the Neuhauser criteria (non-Neuhauser
vestibular migraine or nNVM).
The investigators' hypothesis is that even patients with dizziness outside of the Neuhauser
dVM and pVM spectrum will respond to treatment for vestibular migraine, and thus likely have
migraine as a cause of their dizziness. Previous research by our group has suggested that
such patients do in fact respond to migraine therapy1. A second goal of the study is to
evaluate the comparative efficacy of nortriptyline and topiramate in the treatment of these
three subgroups of patients with vestibular migraine.