A Comparative Study of the Effects of Low-Dose Topiramate Versus Sodium Valproate in Migraine Prophylaxis

Abstract

The present study was performed to evaluate the efficacy of low-dose topiramate and compare it with sodium valproate that is prevalently prescribed as a migraine prophylaxis. This was a randomized, double-blind, parallel-group clinical trial on 56 patients who completed the course of study. Topiramate and valproate were administered at 50 mg/day and 400 mg/day, respectively, during the follow-up period. Frequency, intensity, duration, associated symptoms with headaches, analgesics use, as well as drugs' side effects were studied. Participants completed MIDAS and HIT-6 questionnaires before and after treatment. Frequency, intensity, and duration of migraine headaches as well as MIDAS score and symptomatic medications decreased significantly between repeated follow-up visits in both groups. Responder rate for patients treated with topiramate and valproate were 71.6% and 64.3%, respectively, and the difference between the two groups was not statistically significant. The reduction of headache severity in the topiramate group was significantly more than that in the valproate group (p = .027). During the study, no statistically significant reduction in associated symptoms with migraine were observed in both the groups. Topiramate dose of 50 mg/day with fewer side effects in comparison with its higher doses may be an appropriate substitution for first-line migraine prophylaxis such as valproate.

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“…The MIDAS is sensitive to change over time. [21][22][23] Controlled trials show that the MIDAS is sensitive to treatment effects in both episodic 24,25 and chronic migraine. 26 Responses to the five MIDAS items are summed to a total score where higher scores indicate greater headache-related disability.…”

Effects of Switching Acute Treatment on Disability in Migraine Patients Using Triptans

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Enhanced mindfulness based stress reduction (MBSR+) in episodic migraine: a randomized clinical trial with MRI outcomes

“…(38) These results hold promise for the use of mindfulnessbased interventions for headache, with treatment response rates qualitatively comparable or exceeding effects of most existing standard pharmaceutical therapies in the time frames they have been tested. (39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53) Developing and testing methods to sustain these benefits over longer periods is is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. not certified by peer review) (which was The copyright holder for this preprint this version posted August 6, 2019. .…”