Antiepileptic drugs in the prophylaxis of migraine, chronic headache forms and cluster headache: a review of their efficacy and tolerability

The studies of different antiepileptic drugs (AEDs) in the prophylaxis of episodic migraine, cluster headache (CH) and chronic headache forms (chronic daily headache, transformed or chronic migraine, chronic tension-type headache) are reviewed. The main results from published trials are summarised - focusing on responder rates as reported in placebo-controlled, double-blind studies. Most common adverse events are also discussed. This review indicated that robust evidence supports the use of sodium valproate-divalproex and of topiramate (TPM) in the prophylaxis of migraine, while definitive conclusions about the real effects of other AEDs in migraine cannot be drawn. Overall, evidence of efficacy of different AEDs in chronic headache forms and in CH is still lacking, most studies being open-label, small-sample trials. Nevertheless, encouraging data from controlled trials are emerging for TPM in the treatment of chronic headache forms.