A double-blind, randomized trial of low-dose topiramate vs propranolol in migraine prophylaxis

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.