Levetiracetam in Migraine Prophylaxis

Verma, Archana; Srivastava, Dhiraj Kumar; Kumar, Alok; Singh, Vineeta

doi:10.1097/wnf.0000000000000005

Cited by 27 publications

(14 citation statements)

References 4 publications

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“…The controlled trial reported in chronic daily headache, in which some patients clearly had chronic migraine, was negative (Beran and Spira, 2011). In another placebo-controlled study, showed that LEV at a dose of 1000 mg/day was superior to placebo in relieving migraine frequency, severity and functional disability ( p < 0.0001; Verma et al, 2013). A recent randomized, double-blind, parallel-groups, placebo-controlled study explored the efficacy of LEV (500 mg/day) versus sodium valproate (500 mg/day) versus placebo in the prevention of migraine.…”

Section: Review Of Literature In Migrainementioning

confidence: 99%

Current Status of the New Antiepileptic Drugs in Chronic Pain

Sidhu

Sadhotra

2016

Front. Pharmacol.

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Antiepileptic drugs (AEDs) are extensively used worldwide to treat a wide range of disorders other than epilepsy, such as neuropathic pain, migraine, and bipolar disorder. Due to this situation more than 20 new third-generation AEDs have been introduced in the market recently. The future design of new AEDs must also have potential to help in the non-epileptic disorders. The wide acceptance of second generation AEDs for the management of various non-epileptic disorders has caused the emergence of generics in the market. The wide use of approved AEDs outside epilepsy is based on both economic and scientific reasons. Bipolar disorders, migraine prophylaxis, fibromyalgia, and neuropathic pain represent the most attractive indication expansion opportunities for anticonvulsant developers, providing blockbuster revenues. Strong growth in non-epilepsy conditions will see Pfizer’s Lyrica become the market leading brand by 2018. In this review, we mainly focus on the current status of new AEDs in the treatment of chronic pain and migraine prophylaxis. AEDs have a strong analgesic potential and this is demonstrated by the wide use of carbamazepine in trigeminal neuralgia and sodium valproate in migraine prophylaxis. At present, data on the new AEDs for non-epileptic conditions are inconclusive. Not all AEDs are effective in the management of neuropathic pain and migraine. Only those AEDs whose mechanisms of action are match with pathophysiology of the disease, have potential to show efficacy in non-epileptic disorder. For this better understanding of the pathophysiology of the disease and mechanisms of action of new AEDs are essential requirement before initiating pre-clinical and clinical trials. Many new AEDs show good results in the animal model and open-label studies but fail to provide strong evidence at randomized, placebo-controlled trials. The final decision regarding the clinical efficacy of the particular AEDs in a specific non-epileptic disorder should be withdrawal from randomized placebo trials rather than open-label studies; otherwise this may lead to off-label uses of drug. The purpose of the present review is to relate the various mechanisms of action of new AEDs to pathophysiological mechanisms and clinical efficacy in neuropathic pain and migraine.

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Section: Review Of Literature In Migrainementioning

confidence: 99%

Current Status of the New Antiepileptic Drugs in Chronic Pain

Sidhu

Sadhotra

2016

Front. Pharmacol.

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“…Symptomatic drugs intake reduced from 5.85 (1.55) to 1.87 (1.39) tablets per month (P < 0.0001). No response difference between migraine with or without aura was observed [19]. Double-blind, controlled study performed by de Tommaso in 2008 included 45 patients (35 females and 10 males) having migraine without aura.…”

Section: Resultsmentioning

confidence: 99%

“…In this review, a total of seven studies were included (four open-label trials and three randomized-control trials). Among three randomized trials, two included patients with both migraine with aura and without aura [18,19] and one included patient without aura [20]. While among four open label trials, two included patients with migraine without aura [15,17], third one included patient with aura [16] and the fourth one included patient with aura and without aura [14].…”

Section: Discussionmentioning

confidence: 99%

Levetiracetam for the Prophylaxis of Migraine in Adults

Azeem¹,

Faheem²,

Farooq³

et al. 2021

Cureus

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Migraine is the second most common primary headache disorder after tension-type headache and is the leading cause of disability worldwide. Cortical spreading depression involves neuronal excitation and inhibition and is involved in pathophysiology of migraine. Many anti-epileptic drugs act by inhibiting Cortical Spreading Depression and block desensitization. Anti-convulsants are commonly used in Migraine prophylaxis and the ones being more effective than placebo include Sodium Valproate and Topiramate. Levetiracetam has unique mechanism as it targets hyper-excitable neurons by binding to synaptic vesicle protein. This results in inhibition of neurotransmitter release thus decreases hyperexcitability. Levetiracetam has minimal side effect profile (dizziness, somnolence and mood changes) and it can be well tolerated by patients. In this review, a total of seven studies were included (four open-label trials and three randomized-control trials) which evaluated the role of Levetiracetam in the prophylaxis of migraine in adult patients. On review of this evidence, Levetiracetam appears to be effective in treating migraine with and without aura and is considered safe because of its limited side effects. There was a significant reduction in the frequency, severity, and duration of migraine with a high responder rate. Levetiracetam was well tolerated with minimal side effects and no reported interactions. However, larger randomized controlled trials are needed and these studies should be done on special population to see the outcomes. In addition, studies for extended-release formulations should also be done.

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“…Patients treated with levetiracetam also reported a statistically significant reduction in the quantity of symptomatic drugs needed for symptom control as compared to the placebo group. [ 11 ] In another study, it was shown that levetiracetam was well tolerated in 13 elderly patients with migraine. Moreover, levetiracetam showed a good efficacy in frequency and intensity reduction of headache attacks and showed a very good tolerability despite all elderly patients took drugs for concomitant diseases.…”

Section: Discussionmentioning

confidence: 99%

“…[ 9 ] Studies have shown that levetiracetam has been effective in prophylactic treatment of migraine in elderly[ 10 ] and adult patients. [ 11 ] It has also been shown to be promising in refractory chronic migraine[ 12 ] and for migraine with aura with high frequency of attacks. [ 13 ]…”

Section: Introductionmentioning

confidence: 99%

Comparison of Levetiracetam and sodium Valproate in migraine prophylaxis: A randomized placebo-controlled study

Sadeghian¹,

Motiei-Langroudi²

2015

Ann Indian Acad Neurol

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Background:Migraine is a chronic and disabling disorder. Treatment of migraine often comprises of symptomatic (abortive) and preventive (prophylactic) treatment. The current drugs used in migraine prophylaxis include antidepressant drugs (Serotonin Reuptake Inhibitors, Tricyclic antidepressants), and anti-epileptic drugs (valproate, gabapentin, etc).Objective:The objective of our study was to assess the efficacy and tolerability of levetiracetam in adult migraine prophylaxis, compared to valproate and placebo.Materials and Methods:We conducted a prospective, randomized, placebo-controlled study. A total of 85 patients were randomized to receive levetiracetam 500 mg/d (n = 27), valproate 500 mg/d (n = 32) or placebo (n = 26). The patients were evaluated for treatment efficacy after 6 months. Efficacy was assessed as a more than 50% decrease in headache frequency.Results:In levetiracetam group, 17 (63.0%) patients experienced a more than 50% decrease in headache frequency, while this efficacy number was 21 (65.6%) for valproate group and 4 (15.4%) for placebo group. The difference was not statistically significant between levetiracetam and valproate, while it was significant when comparing either levetiracetam or valproate to placebo.Conclusion:Compared to placebo, levetiracetam offers improvement in headache frequency in patients with migraine. The efficacy of levetiracetam in migraine prophylaxis is comparable to currently used drugs such as valproate.

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Levetiracetam in Migraine Prophylaxis

Abstract: Compared with the placebo group, LEV offers improvement in headache frequency and severity as well as it lowers the requirement for other symptomatic drugs in adult migraine patients.

Cited by 27 publications

References 4 publications

Current Status of the New Antiepileptic Drugs in Chronic Pain

Current Status of the New Antiepileptic Drugs in Chronic Pain

Levetiracetam for the Prophylaxis of Migraine in Adults

Comparison of Levetiracetam and sodium Valproate in migraine prophylaxis: A randomized placebo-controlled study

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