Efficacy of topiramate and valproate in chronic migraine

Clin Neuropharmacol. 2005 Nov-Dec;28(6):277-9. doi: 10.1097/01.wnf.0000192136.46145.44.


Objectives: The aim of this study was to compare the efficacy of sodium valproate and topiramate in treating chronic migraine.

Methods: Forty-nine patients with chronic migraine were randomly assigned to 1 of 2 groups of treatment: 750 mg/day valproate or 75 mg/day topiramate. Efficacy variables were number of days with headache over a 30-day period and changes in Migraine Disability Assessment (MIDAS) scores at 3 months.

Results: At baseline the 2 groups had similar numbers of days with headache and mean MIDAS scores. At the end of the treatment period, a significant reduction in 30-day headache frequency with respect to baseline (P < 0.00001) and a significant reduction in MIDAS scores (P < 0.00001) were recorded in both groups. There were no significant differences in beneficial effects between the 2 drugs.

Discussion: Valproate and topiramate seem to be able to manage successfully chronic migraine without substantial differences in efficacy and tolerability. This affords clear practical advantages-in the event of failure of or intolerance for one treatment, the patient may be switched to the other.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anticonvulsants / therapeutic use*
  • Chronic Disease / drug therapy
  • Demography
  • Drug Evaluation
  • Female
  • Fructose / analogs & derivatives*
  • Fructose / therapeutic use
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders / drug therapy*
  • Neuroprotective Agents / therapeutic use*
  • Time Factors
  • Topiramate
  • Treatment Outcome
  • Valproic Acid / therapeutic use*


  • Anticonvulsants
  • Neuroprotective Agents
  • Topiramate
  • Fructose
  • Valproic Acid