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

Updated: Nov 19, 2019
  • Author: Wendy G Mitchell, MD; Chief Editor: Stephen L Nelson, Jr, MD, PhD, FAACPDM, FAAN, FAAP, FANA  more...
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Answer

Anticonvulsants

When given in doses lower than those generally used for preventing seizures, valproic acid, topiramate, phenobarbital, and phenytoin usually have antimigraine activity. Only divalproex sodium is approved specifically for migraine prophylaxis. Topiramate has been reported to reduce migraine attacks in adults but is not yet approved for migraine prophylaxis in children.

Valproic acid (Depakote)

Divalproex sodium is a stable coordination compound comprising sodium valproate and valproic acid in a 1:1 molar relationship; it is approved by the FDA for prevention of migraine. It is likely that all forms of valproic acid have similar efficacy. Preparations that can be used include 250-mg tablets, 125-mg sprinkle capsules, and 250 mg/5 mL liquid formulations (US preparations).

Gabapentin (Neurontin, Gralise)

Gabapentin is used for migraine headache prophylaxis. It has shown efficacy in migraine and transformed migraine.

Topiramate (Topamax)

Migraine prophylaxis in adults is a labeled indication for topiramate. Studies of this use of the drug in adolescents and children are under way. Topiramate is sedating and causes cognitive slowing if the dose is advanced rapidly or the starting dose is high.


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