Association of MDR1, CYP2D6, and CYP2C19 gene polymorphisms with prophylactic migraine treatment response

J Neurol Sci. 2016 Jul 15:366:149-154. doi: 10.1016/j.jns.2016.05.019. Epub 2016 May 13.


Prophylactic therapy response varies in migraine patients. The present study investigated the relationship between the resistance to the drugs commonly used in prophylactic therapy and the possible polymorphic variants of proteins involved in the metabolism of these drugs. Migraine patients with the MDR1 3435TT genotype exhibited a better treatment response to topiramate than migraine patients with the CC and CT genotypes (p=0.020). The MDR1 C3435T polymorphism was also found to be a higher risk factor for topiramate treatment failure in a comparison of the number of days with migraine (β2=1.152, p=0.015). However, there was no significant relationship between the treatment response to topiramate and either the CYP2D6 or CYP2C19 polymorphism, and there were no significant correlations between the treatment responses to amitriptyline, propranolol, and valproic acid and the MDR1, CYP2D6 and CYP2C19 gene polymorphisms. This is the first study to investigate the effect of the polymorphic variants on prophylactic therapy response in migraine patients.

Keywords: MDR1; Migraine; Polymorphism; Prophylactic therapy response.

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily B / genetics
  • Adult
  • Amitriptyline / therapeutic use
  • Central Nervous System Agents / therapeutic use
  • Cytochrome P-450 CYP2C19 / genetics*
  • Cytochrome P-450 CYP2D6 / genetics*
  • Drug Resistance / genetics
  • Female
  • Fructose / analogs & derivatives
  • Fructose / therapeutic use
  • Gene Frequency
  • Genetic Association Studies
  • Humans
  • Male
  • Migraine Disorders / drug therapy*
  • Migraine Disorders / genetics*
  • Polymorphism, Genetic*
  • Propranolol / therapeutic use
  • Risk Factors
  • Topiramate
  • Treatment Outcome
  • Valproic Acid / therapeutic use


  • ABCB1 protein, human
  • ATP Binding Cassette Transporter, Subfamily B
  • Central Nervous System Agents
  • Topiramate
  • Amitriptyline
  • Fructose
  • Valproic Acid
  • Propranolol
  • CYP2C19 protein, human
  • Cytochrome P-450 CYP2C19
  • Cytochrome P-450 CYP2D6