A double-blind, randomized trial of low-dose topiramate vs propranolol in migraine prophylaxis.
OBJECTIVE
To assess the efficacy and safety of low-dose topiramate in migraine prophylaxis vs propranolol.


METHODS
A randomized, double-blind, clinical trial including 62 patients with frequent migraine headaches (> or = 3 attacks per month) was performed for a period of 8 weeks. The patients were randomly divided into two treatment groups - treated by topiramate 50 mg/day and propranolol 80 mg/day, respectively. The patients were assessed at 0, 4, and 8 weeks of the study. Results - The topiramate group showed a reduction in the mean (+/-SD) of monthly migraine frequency from 6.07 (+/-1.89) to 1.83 (+/-1.39) episodes per month, headache intensity from 7.1 (+/-1.45) to 3.67 (+/-2.1) based on the Visual Analog Scale, and headache duration from 16.37 (+/-7.26) to 6.23 (+/-5.22) hours (P < 0.001). In the patients treated with propranolol, the mean (+/-SD) of monthly headache frequency declined from 5.83 (+/-1.98) to 2.2 (+/-1.67) per month, headache intensity lessened from 6.43 (+/-1.6) to 4.13 (+/-1.94) and headache duration decreased from 15.10 (+/-6.84) to 7.27 (+/-6.46) h (P < 0.001).


CONCLUSIONS
This study demonstrated that both low-dose topiramate and propranolol could significantly reduce migraine headache frequency, intensity, and duration. However, compared with propranolol, low-dose topiramate showed better results.
Ashtari
F
F
Department of Neurology, Isfahan Neurological Sciences Research Centre, Isfahan Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. f_ashtari@med.mui.ac.ir
Shaygannejad
V
V
Akbari
M
M
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects; D001921:Brain / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology; D002536:Cerebral Arteries / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D005260:Female; D005632:Fructose / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control*; D011433:Propranolol / Q000008:administration & dosage* / Q000009:adverse effects; D055502:Secondary Prevention; D012727:Sex Characteristics; D000077236:Topiramate; D016896:Treatment Outcome
D000319:Adrenergic beta-Antagonists; D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose; D011433:Propranolol