MELEK ÖZARSLAN, EMEL UR ÖZÇELİK
Comprehensive Medicine - 2023;15(1):74-80
INTRODUCTION: Managing treatment of migraine attacks, especially migraine attacks with aura may be challenging. Both frequent attacks and drugs used for treatment may lead to some unwanted side effects which affect individuals’ life quality badly. This study aimed to investigate effectiveness of lamotrigine (LTG), an antiepileptic agent and mood stabilizer which has low side effects, that blocks sodium channels, in patients with migraine with aura (MwA) and migraine without aura (MwoA) who have mild-to-moderate depressive and anxious symptoms. METHODS: A prospective, open-label, cross-sectional, and long-term dose titration study was designed. A slow dose-escalation was introduced for LTG: 25 mg/daily for 2 weeks, 50 mg/daily for 2 weeks, and if needed dose increased, not exceeding 200 mg/daily. Dose tapering was planned for after the regular use of 6 months. Ethics Committee approval was obtained and written and verbal consent forms were acquired from participants. Results: The study comprised 128 migraineurs; 78 of them had MwA and 50 of them had MwoA. Mean age of all participants 36.1+9.64 years. In both groups; number of days with headache (p<0.001) and migraine attacks (p<0.001), visual analog scale scores (p<0.001), and MIDAS scores (p<0.001) significantly reduced after treatment. Migraine attack frequency was significantly lower in MwA than MwoA after treatment (p=0.008). DISCUSSION AND CONCLUSION: LTG should be considered as an alternative in prophylaxis of MwA as well as MwoA, especially in treating patients with depressive and anxious complaints and who have tolerance problems to side effects. Randomized, double-blind, and placebo-controlled large-scale studies are needed to prove efficacy of LTG.
