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Background. - Topiramate and sodium valproate are anticonvulsants, demonstrated to be effective as monotherapy for migraine prevention in placebo- controlled trials. Objectives. - To compare the relative efficacy of topiramate and sodium valproate in the prevention of migraine. Patients and Methods. - A 24- week, randomized, double- blind, crossover, clinical trial was conducted from October 2003 to September 2004. A total of 64 patients with migraine headache, aged 14 to 57 years, were randomly allocated to the 2 treatment groups. The first group received topiramate (25 mg daily increment over 1 week to 50 mg) for a total of 2 months. The second group received sodium valproate (200 mg daily increment over 1 week to 400 mg) for 2 months. Response to treatment was assessed at 0, 1, 8, 16, and 24 weeks after start of therapy. Results. - Topiramate appeared to be equivalent in efficacy and safety to sodium valproate. A significant decrease in duration, monthly frequency, and intensity of headache occurred in both groups. Of the 32 patients treated with sodium valproate, the mean standard deviation (SD) of monthly migraine frequency decreased from 5.4 (2.5) to 4.0 (2.8) episode per month, headache intensity from 7.7 (1.2) to 5.8 (1.7) by visual analog scale (VAS), and headache duration from 21.3 (14.6) to 12.3 (10.7) hours (P < .001). Correspondingly, in the 32 patients treated with topiramate, the mean SD of monthly headache frequency decreased from 5.4 (2.0) to 3.2 (1.9) per month, headache intensity from 6.9 (1.2) to 3.7 (1.3), and headache duration from 17.3 (8.4) to 3.9 (2.7) hours (P < .001). Conclusion. - This study demonstrates that treatment with topiramate and sodium valproate both significantly reduce migraine headache. This effect of topiramate and sodium valproate has previously been shown to reduce migraine headache, and we postulate that treatment with topiramate and sodium valproate may have a similar benefit.
Background. - Topiramate and sodium valproate are anticonvulsants, demonstrated to be effective as monotherapy for migraine prevention in placebo-controlled trials. Objectives. - To compare the relative efficacy of topiramate and sodium valproate in the prevention of migraine. Patients and Methods. - A 24-week, randomized, double-blind, crossover, clinical trial was conducted from October 2003 to September 2004. A total of 64 patients with migraine headache, aged 14 to 57 years, were randomly allocated to the 2 treatment groups. The first group received topiramate (25 mg daily increment over 1 week to 50 mg) for a total of 2 months. The second group received sodium valproate (200 mg daily increment over 1 week to 400 mg) for 2 months. Response to treatment was assessed at 0 , 1, 8, 16, and 24 weeks after start of therapy. Results. - Topiramate was to be equivalent in efficacy and safety to sodium valproate. A significant decrease in duration, monthly frequency, and intensity of Of the 32 patients treated with sodium valproate, the mean standard deviation (SD) of monthly migraine frequency decreased from 5.4 (2.5) to 4.0 (2.8) episode per month, headache intensity from 7.7 (1.2) to 5.8 (1.7) by visual analog scale (VAS), and headache duration from 21.3 (14.6) to 12.3 (10.7) hours (P <.001). Correspondingly, in the 32 patients treated with topiramate, the mean SD of monthly headache frequency decreased headache intensity from 6.9 (1.2) to 3.7 (1.3), and headache duration from 17.3 (8.4) to 3.9 (2.7) hours (P <.001). Conclusion. This study demonstrates that treatment with topiramate and sodium valproate both significantly reduce migraine headache. This effect of topiramate and sodium valproate has previously been shown to reduce migraine headache, and we postulate that treatment with topiramate and sodium valproate may have a similar benefit.