Efficacy of topiramate and valproate in chronic migraine.
OBJECTIVE
The aim of this study was to compare the efficacy of sodium valproate and topiramate in treating chronic migraine.


METHODS
Forty-nine patients with chronic migraine were randomly assigned to 1 of 2 groups of treatment: 750 mg/day valproate or 75 mg/day topiramate. Efficacy variables were number of days with headache over a 30-day period and changes in Migraine Disability Assessment (MIDAS) scores at 3 months.


RESULTS
At baseline the 2 groups had similar numbers of days with headache and mean MIDAS scores. At the end of the treatment period, a significant reduction in 30-day headache frequency with respect to baseline (P < 0.00001) and a significant reduction in MIDAS scores (P < 0.00001) were recorded in both groups. There were no significant differences in beneficial effects between the 2 drugs.


CONCLUSIONS
Valproate and topiramate seem to be able to manage successfully chronic migraine without substantial differences in efficacy and tolerability. This affords clear practical advantages-in the event of failure of or intolerance for one treatment, the patient may be switched to the other.
Bartolini
Marco
M
Department of Neuroscience, Polytechnic University of Marche, Via Conca 71, 60020 Ancona, Italy.
Silvestrini
Mauro
M
Taffi
Ruja
R
Lanciotti
Chiara
C
Luconi
Roberta
R
Capecci
Marianna
M
Provinciali
Leandro
L
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D002908:Chronic Disease / Q000188:drug therapy; D003710:Demography; D004341:Drug Evaluation; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000188:drug therapy*; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D013997:Time Factors; D000077236:Topiramate; D016896:Treatment Outcome; D014635:Valproic Acid / Q000627:therapeutic use*
D000927:Anticonvulsants; D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose; D014635:Valproic Acid