Anticonvulsant drugs in migraine prophylaxis

Anticonvulsant drugs have been used in migraine prophylaxis since 1970. In recent years, new antiepileptic compounds have given rise to much interest in pain control. Migraine prophylaxis is still based on old drugs, and physicians facing this condition are always prompted to use any new possible choice. The most studied drug over last decade has been divalproex sodium, and many papers showed its efficacy in the treatment of episodic migraine, chronic migraine, transformed migraine, and related conditions. Valproate is well tolerated and many dosages have been used successfully. For the newer drugs, such as gabapentin, lamotrigine or topiramate, the evidence is less strong but rapidly increasing in the last 3–4 years. We review the principal characteristics of their use, according to dosages, duration of treatments, side effects, and significant efficacy.