Research Update

Drug does not Help Prevent Migraine After All

The severity of migraine attacks and the amount of acute rescue medication required was not affected by treatment allocation

Contrary to some reports, the anti-epilepsy drug oxcarbazepine does not appear to prevent migraine headaches, new research suggests. Anti-epilepsy drugs have been used for the prevention of migraine, Dr Stephen Silberstein of the Jefferson Headache Centre in Philadelphia, and associates note in the journal Neurology—and reports have suggested that oxcarbazepine would be effective as well. In a study lasting almost five months, the investigators randomly assigned 170 men and women with a history of migraine to a daily dose of oxcarbazepine or inactive placebo. Both groups included people who had three to nine migraine attacks within a month.

Results showed no difference between the oxcarbazepine and placebo groups in the change in the number of migraine attacks from the beginning to the end of the study. Similarly, the severity of migraine attacks and the amount of acute rescue medication required was not affected by treatment allocation. "The results of this trial do not support preliminary data which had suggested oxcarbazepine was effective in preventing migraine," Silberstein noted. "While several epilepsy drugs have been used for decades to prevent migraine, oxcarbazepine did not prevent migraine in this study despite it being shown to be safe and well-tolerated."

Silberstein also noted that the three epilepsy drugs that most effectively prevent migraine— topiramate, divalproex and gabapentin— have several mechanisms by which they treat migraine, including the ability to regulate a brain chemical known as GABA. In contrast, oxcarbazepine has no apparent activity on GABA.

Silberstein says it's possible that epilepsy drugs must be able to regulate brain chemical in order to prevent migraine.

Reuters