Seizure medicine to prevent migraine headaches

Examples

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Brand Name	Chemical Name
Depakote	divalproex sodium

Brand Name	Chemical Name
Topamax	topiramate

Brand Name	Chemical Name
Depakene	valproic acid

How It Works

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Topiramate and divalproex sodium are seizure medicines that are typically used to control seizures in people who have epilepsy. These medications are also used to prevent migraine headaches and have been approved by the U.S. Food and Drug Administration (FDA) for this use. Valproic acid has not been approved by the FDA for the treatment of migraine headaches, but it is used to prevent migraines in some people.

Why It Is Used

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These seizure medicines, when they are taken regularly, may help to prevent migraine headaches.

How Well It Works

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One study showed that topiramate was effective at preventing migraines.¹ Divalproex sodium also works well to prevent migraine attacks.²

Side Effects

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Common side effects of topiramate include:

• Fatigue.
• A prickling or tingling sensation in the hands and feet.
• Lack of coordination.
• Loss of appetite and weight loss.
• Inability to concentrate or speak clearly.

Topiramate has been linked in some people to a potentially life-threatening condition called metabolic acidosis, which happens when there is too much acid in the blood. Symptoms include fatigue, lack of appetite, and rapid breathing (hyperventilation). If left untreated, metabolic acidosis can lead to death.

Rarely, topiramate may cause serious side effects, such as:

• Glaucoma, which can lead to blindness.
• An inability to sweat, which can lead to life-threatening fever or heatstroke.

Side effects from divalproex sodium may include:

• Fatigue.
• Nausea.
• Tremor or shakiness.
• Hair loss.
• Weight gain.
• Headache pain that is different than pain from a migraine headache.

Uncommon but potentially life-threatening side effects of divalproex sodium include:

• Liver failure.
• Inflammation of the pancreas.
• Elevated levels of ammonia in the blood (hyperammonemia).

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

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Women who take seizure medicines need to talk with their doctors if they are considering becoming pregnant. Seizure medicines may harm a fetus.

For some people, topiramate may produce side effects or carry risks, including an increased risk of birth defects, that are not yet fully known. Report any unexpected side effects or problems to your doctor.

Topiramate may make birth control pills less effective. A woman who is taking topiramate may need to use another method of birth control to reduce her chances of becoming pregnant.

If you have had kidney stones, be sure to tell your doctor this before you take topiramate. Using topiramate may increase your risk of having kidney stones again.

Complete the new medication information form (PDF) (What is a PDF document?) to help you understand this medication.

References

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Citations

1. Brandes JL, et al. (2004) Topiramate for migraine prevention: A randomized controlled trial. JAMA, 291(8): 965–973.

2. Freitag FG, et al. (2002). A randomized trial of divalproex sodium extended-release tablets in migraine prophylaxis. Neurology, 58(11): 1652–1659.

Credits

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Author	Monica Rhodes
Editor	Kathleen M. Ariss, MS
Associate Editor	Pat Truman
Primary Medical Reviewer	Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer	Colin Chalk, MD, CM, FRCPC - Neurology
Last Updated	July 3, 2007