Lamotrigine in the Prevention of Migraine With Aura

A Narrative Review

Dan Buch, MD; Hugues Chabriat, MD, PhD


Headache. 2019;59(8):1187-1197. 

In This Article


We conducted a systematic search on PubMed. All reports from the literature related to the use of lamotrigine in migraine with or without aura and published prior to April 2019 found using PUBMED and the keywords "migraine" AND "lamotrigine" were analyzed. The initial screening was performed based on eligibility of title and abstract. Original studies published in full, systematic reviews, and all cases series and case reports were used for this synthesis. Exclusion criteria included articles in any language other than English or French.

One hundred and 4 publications were considered eligible for examination: 86 articles were excluded (37 general reviews, 11 fundamental studies, 7 articles related to psychiatric topics, 28 clearly irrelevant, 1 duplicate, and 2 case reports further included in a case series). All clinical results reported with the use of lamotrigine in migraineurs were reviewed, they were obtained from 6 case reports, 4 case series, 3 retrospective studies, 3 open label trials, and 2 randomized controlled trials. MA and migraine without aura (MO) were subsequently considered independently. We also examined the risk profile, pharmacokinetics, and mode of action of lamotrigine in view of the presumed mechanism of MA. The terms lamotrigine* AND pregnancy* OR teratogenicity* OR cortical spreading depression* OR aura* OR pharmacokinetic* OR mechanisms of action* OR Headache* OR hemiplegic migraine* OR FHM* OR CACNA1A* OR ATP1A2* OR SCN1A* OR TRESK* OR CACNA1E* OR vertigo* OR vestibular * were also explored for the narrative part of the review.