Comparing the Effects of Atorvastatin With Sodium Valproate (Divalproex) on Frequency and Intensity of Frequent Migraine Headaches: A Double-blind Randomized Controlled Study

Hesami, Omid; Sistanizad, Mohammad; Asadollahzade, Elnaz; Johari, Mohammad-Sadegh; Moghadam, Nahid Beladi; Mazhabdar-Ghashghai, Homa

doi:10.1097/wnf.0000000000000280

Cited by 14 publications

(8 citation statements)

References 17 publications

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“…Aside from the increased cardiovascular risk, lipid parameters have been associated directly with the increased burden (frequency‐wise) of the disease 63,64 . Furthermore, cholesterol‐lowering medications (namely statins) have demonstrated favorable efficacy properties in the prevention of the disease 65–67 . It is possible that these effects are a subsequent of the improvement of endothelial dysfunction and the reduction of vascular wall inflammation mediated by statins 68 .…”

Section: Discussionmentioning

confidence: 99%

“…63,64 Furthermore, cholesterol-lowering medications (namely statins) have demonstrated favorable efficacy properties in the prevention of the disease. [65][66][67] It is possible that these effects are a subsequent of the improvement of endothelial dysfunction and the reduction of vascular wall inflammation mediated by statins. 68 Aside from the above-mentioned general properties, statins, they downregulate the production of CGRP and substance p, 69 as well as attenuate the NF-kB activation in the trigeminal nucleus caudalis, 70 which are believed to play an important role in the pathophysiology of migraine.…”

Section: Ta B L E 1 Methodological Features and Participant Demograph...mentioning

confidence: 99%

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Serum lipid abnormalities in migraine: A meta‐analysis of observational studies

et al. 2021

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Background: The association of migraine with vascular comorbidities is long-established. The contribution of the "traditional" cardiovascular risk factors to this connection remains unclear. Objective: To determine-quantify the differences in the serum lipid concentrations between lipid-lowering agents-naïve individuals with migraine and healthy controls (HC). Methods: The study protocol was not preregistered with an online systematic reviewprotocol registry. A literature search involving MEDLINE, EMBASE, CENTRAL, Google Scholar, and the OpenGrey database was performed. Case-control, cross-sectional, or cohort studies involving HC and participants with migraine (with and without aura regardless of the use of prophylactic treatment) that quantitatively assessed serum low-density lipoprotein cholesterol (LDL-C) (primary index) and/or total cholesterol (TC) and/or high-density lipoprotein cholesterol (HDL-C) and/or triglycerides (TG) (secondary indices) were retrieved. Articles including participants with known dyslipidemia (or under lipid-lowering medications) or with secondary causes of dyslipidemia (aside from the subjectively assessed lifestyle parameters) were excluded. Studies with abstracts and full texts not published in English and articles reporting the implementation of other study designs (reviews, meta-analyses, commentaries, case reports, etc.) were excluded as well. Conference abstracts and English abstracts from studies with full texts not published in English were evaluated as part of the gray literature. Each step of the review process was performed by two investigators independently, and relevant data were abstracted based on standardized extraction forms. Any discrepancies were resolved by a third investigator. Results: Seventeen studies (16 case-control and 1 cross-sectional) fulfilled the eligibility criteria. Retrieved articles involved adult participants, principally during the fourth decade of life. Results were compatible with higher LDL-C levels in migraine individuals

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Section: Discussionmentioning

confidence: 99%

Section: Ta B L E 1 Methodological Features and Participant Demograph...mentioning

confidence: 99%

Serum lipid abnormalities in migraine: A meta‐analysis of observational studies

et al. 2021

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“…They believed that this may contributed to antinociceptive, anti-inflammatory and antioxidant effects of statins. Moreover, administration of this medication was not accompanied by any specific adverse effects in patients (41). In a case report, it was indicated that initiation of atorvastatin at dose of 20 mg/day for a patient with frequent attacks of typical migraine completely resolved migraine attacks (42).…”

Section: Discussionmentioning

confidence: 98%

Does Atorvastatin Help Prevent Classic Migraine Attacks? A Triple-Blind Controlled Clinical Trial

Ganji¹,

Majdinasab²,

Hesam³

et al. 2020

Preprint

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Background: Migraine is a painful and disabling nervous disorder which negatively affects the quality of life. Migraineurs may suffer from a generalized vasomotor dysfunction. Statins improve vasomotor and vascular function, with their pleiotropic effects. We aimed to assess efficacy and safety of adding Atorvastatin to prophylactic regimen in better control of classic migraine.Methods: This triple-blind controlled clinical trial was on 68 consecutive patients with history of classic migraine. An interval of at least one month was given to evaluate vitamin D3 level and eligibility. In patients with vitamin D3 deficiency, the correction was provided by administration of soft gelatin capsule of vitamin D supplementation. The patients were randomly assigned to receive atorvastatin 20mg plus sodium valproate 500mg or placebo plus sodium valproate 500mg once a day for two months. The patients were evaluated based for the number of attacks and pain severity based on Visual Analogue Scale. Results: There was a significant (p = 0.0001) improvement in severity of pain and number of migraine attacks by adding Atorvastin to the prophylactic regimen of patients. After controlling for variable parameters, the differences between two arms of the study was yet statistically significant (p = 0.0001). A significant number of participants in intervention group were satisfied by their treatment (p = 0.001). There was no remarkable difference in two arms of the study in terms of possible side effects (P =0.315).Conclusions: The results of present study suggested that adding atorvastatin to migraine preventive regimen may help reduce the number of acute attacks and pain severity. This modality did not cause considerable side effects and led to a better patient satisfaction.

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“…Patients exhibit tremors with doses exceeding 1,000 mg/d, according to Hyman's reports (18). Additionally, trials have shown that patients with doses of <500 mg also experience tremor (19,20). In addition, it is not clear whether the dose of VPA compared to other drugs increases the risk of tremors.…”

Section: Introductionmentioning

confidence: 99%

Risk of Valproic Acid-Related Tremor: A Systematic Review and Meta-Analysis

Zhang

et al. 2020

Front. Neurol.

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Purpose: To evaluate the incidence and risk of tremor in patients treated with valproic aid (VPA) monotherapy.Methods: We searched the PubMed, Embase, and Cochrane Library databases to gather relevant data on tremor in patients taking VPA and other drugs and performed a meta-analysis using Stata15.1 software.Results: Twenty-nine randomized controlled trials (RCTs) met the inclusion criteria and were included in the meta-analysis. The overall incidence of tremor in patients receiving VPA therapy was 14% [OR = 0.14, 95% CI (0.10–0.17)]. The pooled estimate risk of tremor showed a significant difference between patients treated with VPA and all other drugs [OR = 5.40, 95% CI (3.22–9.08)], other antiepileptic drugs (AEDs) [OR = 5.78, 95% CI (3.18–10.50)], and other non-AEDs [OR = 4.77, 95% CI (1.55–14.72)]. Both a dose of <1,500 mg/d of VPA [included 500 mg/d: OR = 3.57, 95% CI (1.24–10.26), 500–999 mg/d: OR = 3.99, 95% CI (1.95–8.20), 1,000–1,499 mg/d: OR = 8.82, 95% CI (3.25–23.94)] and a VPA treatment duration of <12 m [included ≤ 3 months: OR = 3.06, 95% CI (1.16–8.09), 3–6 months: OR = 16.98, 95% CI (9.14–31.57), and 6–12 months: OR = 4.15, 95% CI (2.74–6.29)] led to a higher risk of tremor than did other drugs, as did higher doses and longer treatment times.Conclusion: Compared with other drugs, VPA led to a higher risk of tremor, and the level of risk was associated with the dose and duration of treatment.

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Comparing the Effects of Atorvastatin With Sodium Valproate (Divalproex) on Frequency and Intensity of Frequent Migraine Headaches: A Double-blind Randomized Controlled Study

Abstract: This study indicates that atorvastatin could be an alternative for sodium valproate in migraine prophylaxis with comparable efficacy and fewer adverse effects. Multicenter studies with larger sample size are recommended.

Cited by 14 publications

References 17 publications

Serum lipid abnormalities in migraine: A meta‐analysis of observational studies

Serum lipid abnormalities in migraine: A meta‐analysis of observational studies

Does Atorvastatin Help Prevent Classic Migraine Attacks? A Triple-Blind Controlled Clinical Trial

Risk of Valproic Acid-Related Tremor: A Systematic Review and Meta-Analysis

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