Comparison of the Effectiveness of Topiramate and Sodium Valproate in Pediatric Migraine

Abstract

Frequent migraine headaches can have a significant impact on disability, prompting the need for early recognition and treatment. The objective of this study is to compare the efficacy of topiramate and sodium valproate for the prevention of pediatric migraine, retrospectively. Mean monthly migraine frequency, intensity, and duration in the 28 patients treated with topiramate decreased from 15.3 +/- 10.1 to 4.4 +/- 5.5 episode, from 6.8 +/- 1 to 3.2 +/- 1, and from 10.2 +/- 9.4 to 2.4 +/- 3.1 hours, respectively. Headache disability improved with a reduction of Pediatric Migraine Disability Assessment score from 36 +/- 29.5 to 4.6 +/- 6.5 (P < .05). Similarly, mean monthly headache frequency, headache intensity, headache duration, and Pediatric Migraine Disability Assessment score in the 20 patients treated with sodium valproate decreased from 20.1 +/- 10.2 to 6.6 +/- 8.6, from 7.1 +/- 1 to 3.4 +/- 2.1, from 7 +/- 12 to 1.4 +/- 2.5 hours, and from 20.5 +/- 16.1 to 5.5 +/- 9.2, respectively (P < .05). In conclusion, valproate and topiramate seem to be able to manage successfully childhood migraine without substantial differences in efficacy.

Prophylaxis of Migraine in Children and Adolescents

“…In those children treated with valproic acid, mean monthly headache frequency, headache intensity, headache duration, and PedMIDAS scores decreased from 20.1 ± 10.2 to 6.6 ± 8.6, from 7.1 ± 1 to 3.4 ± 2.1, from 7 ± 12 to 1.4 ± 2.5 h, and from 20.5 ± 16.1 to 5.5 ± 9.2, respectively (p \ 0.05) [24]. In another 12-month, open-label study involving adolescents (n = 112), patients were placed on the extended release form of divalproex in dosages ranging from 250-1000 mg per day.…”

“…In a retrospective study comparing the effectiveness of valproic acid with topiramate, Unalp et al [24] reported that both treatments demonstrated effectiveness in preventing migraines in children. In those children treated with valproic acid, mean monthly headache frequency, headache intensity, headache duration, and PedMIDAS scores decreased from 20.1 ± 10.2 to 6.6 ± 8.6, from 7.1 ± 1 to 3.4 ± 2.1, from 7 ± 12 to 1.4 ± 2.5 h, and from 20.5 ± 16.1 to 5.5 ± 9.2, respectively (p \ 0.05) [24].…”

Recent developments in pediatric headache

“…In an open-label study of divalproate there was a significant reduction in headache frequency [63,64], whereas a comparative study of topiramate and valproic acid found both medications to be effective in decreasing the frequency, severity, duration and PedMIDAS score at a similar rate [65].…”

Propranolol versus topiramate in prophylaxis of migraines among children and adolescents: a randomized, double-blind clinical trial

“…The most frequent reported side effects were weight loss, anorexia, abdominal pain, sedation, paresthesias, and difficulties in concentration. [15][16][17][18][19] No dropouts occurred in our study due to adverse effects. To the best of our knowledge, the current study is the first study that compares the effectiveness of propranolol and topiramate treatment as a prophylaxis of migraine headaches among children and adolescents residing in rural areas.…”

“…15 Some studies have showed the effectiveness of topiramate in reducing monthly migraine frequency in children. [16][17][18][19] We conducted a randomized, double-blind clinical trial to evaluate the efficacy and safety of propranolol and topiramate as preventive treatments for migraine headaches among children and adolescents residing in rural area.…”