Lamotrigine in the prophylactic treatment of migraine aura - a pilot study

The aim of this study was to evaluate the efficacy of lamotrigine, a glutam ate antagonist blocking voltage-sensitive sodium channels, in the prophylax is of migraine aura symptoms, Glutamate is one of the main neurotransmitter s involved in the development of cortical spreading depression, The study w as conducted as an open longitudinal trial over 7 months, with a treatment phase of 4 months and a post-treatment period of 3 months. Thirteen patient s suffering from migraine with aura and 2 patients with aura but without mi graine were enrolled and treated with lamotrigine. The dose was gradually i ncreased in steps of 25 mg up to 100 mg per day, depending on the patient's aura symptoms. Aura symptoms were reduced from baseline tan average of 1.3 aura episodes per month) to month 4 (0.1, p<0.001). High statistical signi ficance was also observed with regard to aura duration (23 min at baseline vs 4 min at 4 months, p<0.001). In all 15 cases, increases in aura frequenc y ton average sevenfold, p<0.001) and aura duration (minutes; on average mo re than threefold, p<0.001) were evident following cessation of treatment. A number of mild to moderate adverse events without any medical consequence s occurred. The study outcome suggests that lamotrigine is effective in pre venting migraine aura symptoms and in influencing migraine headache frequen cy.