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Botulinum Toxin Type A and Divalproex Sodium for Prophylactic Treatment of Episodic or Chronic Migraine
Author(s) -
Blumenfeld Andrew M.,
Schim Jack D.,
Chippendale Thomas J.
Publication year - 2008
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/j.1526-4610.2007.00949.x
Subject(s) - medicine , migraine , tolerability , placebo , adverse effect , botulinum toxin , chronic migraine , anesthesia , gastroenterology , pathology , alternative medicine
Objective.— To compare the efficacy and safety of botulinum toxin type A (BoNTA; BOTOX ® : Allergan, Inc.) and divalproex sodium (DVPX; DEPAKOTE ® : Abbott Laboratories) as prophylaxis in reducing disability and impact associated with migraine. Background.— There is a need for effective, well‐tolerated prophylactic treatment of migraine. Design/Methods.— This was a randomized, double‐blind, single‐center prospective study. Fifty‐nine patients received either BoNTA 100 U/placebo‐DVPX bid or placebo‐BoNTA/DVPX 250 mg bid. BoNTA/placebo injections were given at Day 0 and at Month 3. Patients were evaluated at Months 1, 3, 6, and 9. Results.— Both treatments showed significant improvements in migraine disability scores and reductions in headache days and headache index. A trend to decreased headache severity was observed with BoNTA. A greater percentage of DVPX patients reported adverse events possibly related to treatment (DVPX 75.8% vs BoNTA 50%, P = .04) and discontinued because of adverse events (DVPX 27.6% vs BoNTA 3.3%, P = .012). Conclusions.— Both BoNTA and DVPX significantly reduced disability associated with migraine; BoNTA had a favorable tolerability profile compared with DVPX.