Anticonvulsants: Migraine prophylaxis

Anticonvulsionantes: Profilaxis de migraña

Multiple medications have been used in the prophylaxis of migraine and within these the anticonvulsants such as valproic acid, topiramate and gabapentin have shown utility in decreasing the number and severity of attacks in about 50%. Its mechanisms of action involve interactions with the channels of Na, K, Cl, Ca and neurotransmitters such as glutamate, GABA and Ca, by which AC regulate cortical hyperexcitability and neuromodulatory dysregulation that constitute the main pathophysiological alterations in migraine. Among ACs, valproic acid has greater prophylactic action and similar effectiveness to that achieved with propranolol. Neither can be considered a choice and individualization of the patient is the main guide for the selection of the type of prophylactic drug. Abbreviations: MG, migraine; AC, anticonvulsants; GABA, gamma-aminobutyric acid; AMPA, α-amino-3-hydroxy-5-methyl-4-isoxalone propionic acid; AVP, valproic acid; TPM, topiramate; GPT, gabapentin; LTG, lamotrigine.

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