A comparative study of the effects of low-dose topiramate versus sodium valproate
in migraine prophylaxis.
Author(s): Afshari D, Rafizadeh S, Rezaei M.
Affiliation(s): Department of Neurology, Kermanshah University of Medical Sciences, Kermanshah,
Islamic Republic of Iran.
Publication date & source: 2012, Int J Neurosci. , 122(2):60-8
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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