Objective – To assess the efficacy and safety of low-dose topiramate in migraine prophylaxis vs propranolol.
Patients and methods – A randomized, double-blind, clinical trial including 62 patients with frequent migraine headaches (≥ 3 attacks per month) was performed for a period of 8 weeks. The patients were randomly divided into two treatment groups – treated by topiramate 50 mg/day and propranolol 80 mg/day, respectively. The patients were assessed at 0, 4, and 8 weeks of the study.
Results – The topiramate group showed a reduction in the mean (±SD) of monthly migraine frequency from 6.07 (±1.89) to 1.83 (±1.39) episodes per month, headache intensity from 7.1 (±1.45) to 3.67 (±2.1) based on the Visual Analog Scale, and headache duration from 16.37 (±7.26) to 6.23 (±5.22) hours (P < 0.001). In the patients treated with propranolol, the mean (±SD) of monthly headache frequency declined from 5.83 (±1.98) to 2.2 (±1.67) per month, headache intensity lessened from 6.43 (±1.6) to 4.13 (±1.94) and headache duration decreased from 15.10 (±6.84) to 7.27 (±6.46) h (P < 0.001).
Conclusion – This study demonstrated that both low-dose topiramate and propranolol could significantly reduce migraine headache frequency, intensity, and duration. However, compared with propranolol, low-dose topiramate showed better results.