Efficacy and mechanism of anticonvulsant drugs in migraine.

Efficacy and mechanism of anticonvulsant drugs in migraine.
Expert Rev Clin Pharmacol. 2014 Feb 5;
Authors: Hoffmann J, Akerman S, Goadsby PJ
Abstract
Anticonvulsants represent one of the main substance classes used for the preventive treatment of migraine. Efficacy has been demonstrated in randomized placebo-controlled trials for topiramate and valproic acid including divalproex sodium. In the case of topiramate, efficacy has recently been proven for chronic migraine and even medication overuse headache, questioning the established concept of medication withdrawal. However, preventive treatment with anticonvulsants is frequently hampered by side effects that occasionally require treatment discontinuation. In addition, these data indicate that some anticonvulsant drugs are effective in migraine, while a number are clearly not useful. Effective anticonvulsants, such as topiramate and valproate, target nociceptive trigeminovascular and trigeminothalamic dural pathways or mechanisms involved in cortical spreading depression. Dissecting out how the anticonvulsants that do not work differ mechanistically from those that do will almost certainly provide avenues through which one can develop new treatments to bring to patients with migraine.
PMID: 24494792 [PubMed - as supplied by publisher]

Source: Pharmacological Reviews - February 5, 2014 Category: Drugs & Pharmacology Authors: Hoffmann J, Akerman S, Goadsby PJ Tags: Expert Rev Clin Pharmacol Source Type: research