Antiepileptics in Migraine Prophylaxis: A Review

the MPR take:

An updated review of the use of antiepileptic drugs as preventive treatment for episodic migraine has been published in the journal Cephalagia.  Based on results from recent clinical trials, researchers were able to conclude that the antiepileptic agents that proved to be most effective for prophylactic treatment of migraine included topiramate, sodium valproate, and divalproex.  Mean headache frequency was significantly lower for patients taking topiramate and sodium valproate vs. placebo.  Also, patients on topiramate and divalproex were more likely to report a ≥50% reduction in migraine attack. Topiramate 100mg and 200mg did better in clinical trials than the 50mg dose; however, the higher doses were associated with more adverse effects. Within the study data, no other antiepileptic drug proved to be effective; the evidence also did not support the use of gabapentin for migraine prophylaxis.

New Recommendations on Antiepileptics in Migraine Prophylaxis
New Recommendations on Antiepileptics in Migraine Prophylaxis

Introduction: The efficacy of several antiepileptics in the preventive treatment of episodic migraine in adults has been systematically reviewed. Because many trial reports have been published since then, an updated systematic review was warranted.