Anti-Seizure Drugs
Anti-seizure drugs, also called anti-epileptics or anticonvulsants, affect the neurotransmitter gamma aminobutyric acid (GABA), which helps prevent nerve cells from over-firing. GABA may also have a role in migraines. These drugs are commonly used for epilepsy and bipolar disease. Anti-seizure drugs are more expensive than other drugs. They also have significant side effects. Some experts, then, recommend them only as second-line prevention after older drugs have failed.
Valproate and Divalproex Sodium. Valproate (Depakene) and a similar drug, divalproex sodium (Depakote), are the only drugs approved for preventing migraines. Studies report that valproate reduces migraine frequencies by 30 - 50% or greater by the end of 1 year, after which the benefits remain stable.
Gabapentin (Neurontin). A 2001 multicenter study found that 2,400 mg/day of gabapentin may be an effective preventive drug for patients with migraine headaches. Side effects are similar to those of valproate and may include sleepiness, dizziness, fatigue, and weight gain.
Topiramate (Topamax). In 2004, the FDA approved topiramate for prevention of migraines in adults. Studies from 2006 indicated that the drug works well when used on a long-term basis. Patients in these studies experienced significantly fewer migraines for up to 14 months. Another 2006 study, presented at the American Headache Society meeting, reported that topiramate may help reduce the frequency and severity of migraine attacks in people who experience chronic daily headache. Topiramate’s most common side effect is a tingling sensation in the arms and legs. Weight loss is also a side effect. In clinical trials, patients lost an average of 3.8% of their body weight.
Levetiracetam (Keppra). Levetiracetam significantly reduces the frequency and impact of headaches in patients with transformed migraine, according to a study presented at the 2004 meeting of the American Academy of Neurology. Earlier studies suggested that levetiracetam, when used alone and in combination with other treatments, can help provide migraine pain relief.
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