LOW-DOSE SODIUM VALPROATE IN THE PROPHYLAXIS OF MIGRAINE

The potential therapeutic effect of sodium valproate (VPA) on the prop hylaxis of migraine was assessed in 62 consecutive patients with sever e migraine with and without aura subjected to an open label trial. Pat ients were given 400 mg VPA daily, divided in two oral doses, during 3 months and then asked to withdraw the drug for 3 months. The therapeu tic response was measured with a scale of 15 items that assess the fre quency and severity of migraine attacks, and the possible toxic side-e ffects were monitored by determinations of blood cells, liver enzymes, serum ammonia levels, and plasma VPA levels. Results indicate that 69 .8% of patients obtained substantial benefit from this drug and that t his beneficial effect lasted for at least 3 months after drug withdraw al in 67.6% of cases. No significant correlation was found between VPA levels and the therapeutic response as measured by the Migraine Asses sment Scale. No serious side-effects were observed during the trial. L ow-dose VPA is a safe alternative in the prophylaxis of severe migrain e.