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An Analysis of the “Carry-over Effect” Following Successful Short-term Treatment of Transformed Migraine With Divalproex Sodium

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Address all correspondence to Dr. John F. Rothrock, University of South Alabama, Department of Neurology, MCSB 1155, 2451 Fillingim Street, Mobile, AL 36617.

Abstract

Objective.– To determine whether successful short-term prophylactic treatment of transformed migraine may be followed by a continued respite from headaches once the treatment has been discontinued (“carry-over effect”).

Background.– The optimal duration of prophylactic treatment for pervasive headache and for migraine, in particular, is unknown.

Methods.– We prospectively evaluated a series of patients with transformed migraine, all of whom were managed according to a uniform treatment protocol involving prophylactic therapy with divalproex sodium for a period not exceeding 12 weeks. All patients reporting a positive treatment response were followed for at least 2 months after the discontinuation of divalproex sodium, and the incidence of the carry-over effect in that group was assessed.

Results.– A short-term carry-over effect occurred in 12 (60%) of 20 patients, but more sustained relief occurred in only 8 (40%).

Conclusions.– The successful short-term treatment of transformed migraine with divalproex sodium will often produce a short-term carry-over effect, but this response will be sustained only in a minority of patients.

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