Antiepileptics in migraine prophylaxis: an updated Cochrane review.

Published

Journal Article (Review)

INTRODUCTION: The efficacy of several antiepileptics in the preventive treatment of episodic migraine in adults has been systematically reviewed. Because many trial reports have been published since then, an updated systematic review was warranted. METHODS: We searched the Cochrane Central Register of Controlled Trials, PubMed/MEDLINE (1966 to January 15, 2013), MEDLINE In-Process (current week, January 15, 2013), and EMBASE (1974 to January 15, 2013) and hand-searched Headache and Cephalalgia through January 2013. Prospective, controlled trials of antiepileptics taken regularly to prevent the occurrence of migraine attacks, to improve migraine-related quality of life, or both, were selected. RESULTS: Mean headache frequency on topiramate and sodium valproate is significantly lower than placebo. Likewise, topiramate and divalproex demonstrated favorable results for the proportion of subjects with ≥ 50% reduction of migraine attacks. For topiramate, 100 mg and 200 mg outperformed 50 mg, but this was paralleled by a higher adverse event rate. For valproate/divalproex, a dose-effect correlation could not be established. There was no unequivocal evidence of efficacy for any of the other antiepileptics. CONCLUSION: Topiramate, sodium valproate and divalproex are effective prophylactic treatments for episodic migraine in adults. In contrast to previous reports, there is insufficient evidence to further support the use of gabapentin.

Full Text

Duke Authors

Cited Authors

  • Mulleners, WM; McCrory, DC; Linde, M

Published Date

  • January 2015

Published In

Volume / Issue

  • 35 / 1

Start / End Page

  • 51 - 62

PubMed ID

  • 25115844

Pubmed Central ID

  • 25115844

Electronic International Standard Serial Number (EISSN)

  • 1468-2982

International Standard Serial Number (ISSN)

  • 0333-1024

Digital Object Identifier (DOI)

  • 10.1177/0333102414534325

Language

  • eng