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    Divalproex Sodium and Topiramate for Migraine ProphylaxisMigren
    (Derman Medical Publ, 2012) Degirmenci, Yildiz; Karagoz, Erkan Taner; Karaman, Handan Isin Ozisik
    Aim: To compare the efficacy, safety of topiramate and extended-release divalproex sodium in migraine prophylaxis. Material and Method: Study groups consisted of 22 patients with chronic migraine, randomly administered 1000mg extended-release divalproex sodium (first group), 21 patients given 100mg topiramate (second group).Study was 28-week randomized, prospectivetrial including 4-week baseline, 4-week titration, 20-week maintenancephase.Primary efficacy measure was reduction from baseline in 4-weekmigraine frequency.Secondary efficacy measures included responder rates,mean reduction in migraine duration,severity.Severity of headache wasquantified by using 10-point visual analogue scale (VAS). Responder rateswere defined as percentage of patients who demonstrated = 50%. reductionin migraine frequency per month. Results: Reduction from baseline migrainefrequency at the end of six month was primary outcome measure.Meanmigraine frequency at the end of study was 1.27 +/- 1 (baseline; mean +/- SD:3.6 +/- 2) in the first, 1.2 +/- 1.2 (baseline; mean +/- SD: 3.5 +/- 2.3) (p<0.0001) inthe second gr nt in frequency was observed in 16 patients (72.7%) in the first group, and 16 patients (76.2%) in the second group.Only a limited number of patients were excluded from the study due to side effects as 2 patients from the first group and 1 patient from the second group.The most common side effect was weight gain in the first and paresthesia in the second group. Discussion: Both divalproex sodium, topiramate were almost equally effective in reducing migraine frequency, duration, severity.Total relief from migraine attacks were more in topiramate than extended-release divalproex sodium.