Clopidogrel as prophylactic treatment for migraine: a pilot randomised, controlled study.
BACKGROUND
Anecdotal reports suggest that clopidogrel may prevent migraine attacks. We undertook a pilot randomised trial.


METHODS
We randomised consecutive migraineurs with four to 15 headache days per 28-day month to receive clopidogrel 75 mg or placebo daily for three months. Headache was primarily assessed with a headache diary.


RESULTS
There were no statistically significant treatment effects. The number of headache days fell by 1.9 on clopidogrel and 1.6 on placebo (adjusted difference 0.02, CI -2.07 to 2.12). Headache severity rose by 0.14 points (out of 10) on clopidogrel, and fell by 0.63 on placebo; treatment effect 0.7 points (CI -0.11 to 1.57). The main treatment effect did not depend on the presence or absence of migraine with aura at baseline, a patent foramen ovale (PFO) or atrial septal aneurysm.


CONCLUSIONS
The evidence is inconclusive, but a multicentre trial would be feasible recruiting from primary care.
Cardiothoracic Centre, St Thomas Hospital, UK john.chambers@gstt.nhs.uk.
John B
JB
Chambers
Division of Women's Health, Women's Health Academic Centre, King's College London and King's Health Partners, UK.
Paul T
PT
Seed
Unit of Neurology and General Practice, Department of Clinical Neuroscience, Institute of Psychiatry, King's College London, UK.
Leone
L
Ridsdale
D000328:Adult; D000077144:Clopidogrel; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000517:prevention & control*; D010865:Pilot Projects; D058921:Purinergic P2Y Receptor Antagonists / Q000627:therapeutic use*; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
D058921:Purinergic P2Y Receptor Antagonists; D000077144:Clopidogrel; D013988:Ticlopidine
Migraine; clopidogrel