Role of Antiepileptic Drugs as Preventive Agents for Migraine
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Migraine is a common neurological disease affecting about 12% of the population in Western Europe and North America, and causing a considerable burden both to migraineurs and to society. Severe, frequent and disabling migraine attacks, as well as those poorly responsive to acute care medication, require preventive treatment, which is often under-utilized. Antiepileptic drugs are used in the prevention of migraine.
We performed a literature search of PubMed through June 2008 for controlled trials of antiepileptic drugs in the prevention of migraine. The search identified 70 papers for a full-text review. The majority of these papers referred to valproate and topiramate, and showed that these drugs are effective and well tolerated in migraine prevention and are suitable for first-line clinical use. On the other hand, acetazolamide, lamotrigine, oxcarbazepine and vigabatrin have been shown to be not effective and gabapentin requires further evaluation. For the rest of the antiepileptic drugs, no data from controlled trials are available.
KeywordsMigraine Valproate Gabapentin Lamotrigine Topiramate
No funding or external support has been received for conducting this review and for the preparation of the manuscript.
The authors report the following possible conflicts of interest. Michail Vikelis is currently a part-time medical advisor for Janssen-Cilag, Hellas. In the past he has worked as a medical advisor for MerckSerono, Hellas. Alan Rapoport is on the speakers’ bureau for Endo, Merck, Pfizer and Forest. He is on the advisory board of MAP, Zogenix, NuPathe and Pfizer. In the past, he has been on the speakers bureau of Ortho-McNeil, GlaxoSmithKline, AstraZeneca and Valiant.
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