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Review: anticonvulsants are better than placebo for reducing the frequency of migraine attacks

Clinical impact ratings GP/FP/Primary care IM/Ambulatory care Neurology

Key Words: anticonvulsants • pain

The first 150 words of the full text of this article appear below.

METHODS
Data sources: Medline (up to April 2003); the Cochrane Central Register of Controlled Trials (up to April 2003); review article references; books on headache; contact with drug companies, authors, and experts; and hand searches of Headache and Cephalalgia.

Study selection and assessment: randomised controlled trials (RCTs) that compared anticonvulsants given regularly during headache free intervals in adults >18 years of age with placebo, no intervention, other drug treatments, or behavioural or physical therapies. Methodological quality was assessed using the Jadad 5 point scale.

Outcomes: headache frequency (number of migraine attacks measured at 28 d), headache index measures (frequency and intensity or duration), and adverse events.

MAIN RESULTS
15 RCTs met the selection criteria. Anticonvulsants investigated were divalproex sodium (500–1500 mg daily [4 RCTs]), topiramate (50–200 mg daily [3 RCTs]), sodium valproate (800–1500 mg daily [2 RCTs]), gabapentin (1200–2400 mg daily [2 RCTs]), carbamazepine (dose not reported [1 RCT]), clonazepam (1 mg . . . [Full text of this article]

Alexander W Chessman, MD

Medical University of South Carolina
Charleston, South Carolina, USA