Patients with frequent episodic and chronic migraine, which is often complicated with drug abuse, are resistant to treatment. An objective of the study was to evaluate the efficacy and safety of topalepsin (topiramate) in the preventive treatment of migraine. Thirty patients with frequent episodic and chronic migraine were treated with topalepsin (100 mg daily) during 6 months. After treatment, there was a significant reduction in the number of days with headache and migraine attacks as well as their duration, severity of concomitant symptoms and amount of analgesics used by patients.