Topiramato no tratamento preventivo da migrânea. Variação da resposta após mudança para genérico. Relato de caso. Topiramate in the preventive treatment of migraine. Response variation after switching to the generic formulation. Case report.

The use of generic drugs has been disseminated in Brazil due to the better costs and a pushing behavior of pharmacists. In epileptic patients, the switching from original preparations to generics may trigger seizures or change the tolerability profile promoted by the variations in plasmatic levels and bioequivalence between the different preparations. However, in migraine prevention there are no studies so far evaluating the effects of original and generic anticonvulsants regarding effectiveness and tolerability. We report the case of a patient with migraine without aura who had an increasing frequency of attacks after switching from Topamax® to a generic topiramate. In addition, the patient improved after returning to the original topiramate.