Which medications in the drug class Anticonvulsants are used in the treatment of Migraine Headache?

Updated: Oct 21, 2019
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Anticonvulsants

These drugs can be effective in prophylaxis of migraine headache.

Valproic acid (Depakote, Depacon, Depakene, Stavzor)

Valproic acid reduces the frequency of migraines. This agent is believed to enhance gamma-aminobutyric acid (GABA) neurotransmission, which may suppress events related to migraine that occur in the cortex, perivascular sympathetics, or trigeminal nucleus caudalis. Divalproex has been shown to reduce migraine frequency by 50%.

Topiramate (Topamax, Qudexy XR, Topiragen, Trokendi XR)

Topiramate is indicated for migraine headache prophylaxis in adults and adolescents aged 12 years or older. Its precise mechanism of action is unknown, but the following properties may contribute to its efficacy:

• Blockage of voltage-dependent sodium channels

• Augmentation of activity of the neurotransmitter GABA at some GABA-A receptor subtypes

• Antagonization of the alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA)/kainate subtype of the glutamate receptor

• Inhibition of carbonic anhydrase, particularly isozymes II and IV


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