Comparing Zonisamide With Sodium Valproate in the Management of Migraine Headaches: Double-Blind Randomized Clinical Trial of Efficacy and Safety

Abstract

BackgroundMigraine is one of the most debilitating medical conditions and has a high socioeconomic burden. As conventional therapeutic methods do not entirely alleviate the symptoms, new alternatives are being considered.ObjectivesThis study evaluates the efficacy and safety of zonisamide compared with sodium valproate in the management of migraine headaches.Patients and MethodsIn the current double-blind, parallel, randomized, controlled trial, 96 patients with a migraine diagnosis based on the international headache society (HIS) criteria were selected. They were divided randomly into two groups; the case group was given zonisamide, and sodium valproate was given to a control group. In addition to the side effects of the drugs, the severity, duration, and frequency of migraine attacks were evaluated at baseline and at three months.ResultsThe 96 selected patients were divided randomly into two treatment groups (zonisamide n = 48, sodium valproate n = 48). Seven patients were excluded from analysis because of early dropout, leaving 89 (n = 45; n = 44) patients for analysis. While using zonisamide, six (13%) patients complained of fatigue, and two (4%) patients encountered noticeable appetite and weight loss. In the control group, five (11%) patients reported dizziness, and four (9%) patients faced obvious appetite and weight gain. Both drugs were considerably efficient in reducing further attacks. There was no statistically significant correlation between frequency or severity of migraine attacks and the drug used for treatment in three months of follow-up.ConclusionsBoth medications are effective in reducing migraine attacks. It will be important to consider the drugs’ adverse effects and availability and patients’ medical and socioeconomic condition to select the appropriate treatment.

The Effect of Zonisamide and Ethanol on Various Types of Memory in Rats

“…The drug has a good long-term tolerability and the majority of adverse events seem to be mild-to-moderate [26,27]. Because of its multidirectional mechanism of action, the efficacy of zonisamide is investigated not only in the treatment of alcohol dependence [2,12,13], but also for other central disorders such as Parkinson's disease and dementia with Lewy bodies [28], migraines [29], and eating disorders [30].…”

Consensus of the Brazilian Headache Society (SBCe) for the Prophylactic Treatment of Episodic Migraine: part I

“…Two randomized double-blinded studies 86 , 87 that compared ZNZ and another prophylactic drug for EM prophylaxis were evaluated. In one, 86 ZNZ was superior to topiramate in reducing the intensity of migraine attacks; in the other, 87 ZNZ had an efficacy similar to that of valproate, differing from the latter only in terms of adverse events.…”