Valproate therapy in "refractory migraine" (A 3-month study)

B. Colombo, F. Martinelli Boneschi, P. Rossi, N. Canal

Research output: Contribution to journalArticlepeer-review


Objective. To assess the clinical response and evaluate predictive factors of responsiveness of mg-valproate (VP) as a prophylactic agent in migraine patients who have been not responsive to at least two prophylactic medications prior to VP administration. Background. Several studies indicate that VP may be useful in the prophylaxis of severe migraine headache. A recent statement by American Academy of Neurology (AAN) suggests that VP has a good clinical profile and good strength of evidence. Results. A total of 45 patients were included into the study (12 male; 33 female) (mean age: 36.1, ranging from 25 to 46 years). Thirteen patients had migraine with aura (MWA) and 32 without aura (M). Average duration of the disease was 11.7 years. All patients had tried at least two other ineffective medications before being included in the study. Initial dosage was titrated in 1 month to 500 mg. The final dose at 3 months ranged from 750 to 1200 mg. Of the patients treated with VP 60% were considered to be responders (50% reduction after therapy of number of headache days). Positive predictive factors in terms of being responsive was the diagnosis of MWA (P=0,04; logistic regression); a positive trend was also found for patients with depression comorbidity. Side effects were reported in 2/3 of the patients. Most important were weight gain (33%) and nausea (24.5%). At the end of the study (3 months) we didn't have any drop-out patients. Conclusion. The results of this 3-month open-label study showed an important efficacy of VP in terms of reduction of days of headache even in a short period. A positive predictive factor of efficacy of the drug was the diagnosis of MWA. Side effects, present in most of the patients, were not severe enough to induce drop-out during the study.

Original languageEnglish
JournalNeurological Sciences
Issue number4 SUPPL.
Publication statusPublished - 2000

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology


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