A Comparison of Divalproex With Propranolol and Placebo for the Prophylaxis of Migraine Without Aura

摘要: Objective: To compare the efficacy of divalproex sodium (Depakote) with that propranolol hydrochloride (and placebo) for prophylaxis migraine without aura. Design: Single-investigator, randomized, single-blind, placebo-controlled study 5 phases: baseline (weeks 1-4); placebo 5-8); first treatment, 1 agent 9-20); washout 21-24); and second crossover to other 25-36). Setting: Private practice a general neurologist special interest in headache disorders. Patients: Of 37 patients (30 women 7 men) selected, 32 completed study. All received placebo, after which half were randomized receive or propranolol, then crossed over washout. Intervention: Divalproex doses titrated during initial 8 weeks each 12-week treatment cycle. For divalproex, 1500 mg/d 23 patients, 2000 2, downward 7; mean valproate trough level was 68.5 mg/L. Propranolol 180 28 240 1, 3. Results: Migraine frequency reduced 19% (6/32) placebo-treated, 66% (21/32) divalproextreated, 63% (20/32) propranolol-treated patients. Assessment migraine-days per month revealed significant response 22% (7/32) (21/32), 69% (22/32). When results limited third active-agent phase, 75% (24/32) receiving 78% (25/32) those had reduction frequency. Conclusion: No difference identified between