Rahul Kumar,Sarvesh Singh, Anil Kumar Saksena,Narendra Kumar, Akhlaque Ahmad and Manoj Kumar
King George’s Medical University India
Posters & Accepted Abstracts: Pharmaceutical Analysis
Pharmacological prophylaxis for migraine consists of a long list of drugs. Beta blockers, antidepressants, antiepileptics, calcium channel blockers, pregabalin, levetiracetam, etc. The main drugs utilized for a long time and a number of studies have been conducted to investigate their efficacy in migraine prophylaxis. To assess the effectiveness of well-known drugs and some newer ones we searched last fiveyear, original research articles on MEDLINE, Google Scholar and EMBASE on 15th February 2019. We selected randomized or quasi-randomized trials of drugs used in migraine prophylaxis. We didn’t compare each of them but searched for their effectiveness individually. Percentage reduction in attack frequency was evaluated. We found 41 studies out of which we include 14 studies. We excluded animal studies, abstract with only papers and studies with missing data. Amitriptyline was found to be most effective ranging from 60% to 83%. Sodium valproate was the most studied drug with 60% to 78% reduction in attack frequency after two months. Pregabalin showed 65% reduction in attack frequency after two months treatment. Levetiracetam found to be effective by 58% to 70% reduction in attack frequency. Flunarizine effectiveness ranges from 46% to 76%. Erenumab (a human monoclonal antibody which blocks calcitonin gene related receptor) also showed 50% reduction in attack frequency. Fremanezumab (quarterly administration) is moderately effective with 40% reduction in attack frequency. Reduction in attack frequency was 63% by melatonin. Omega 3 polyunsaturated fatty acids showed 66% reduction in attack frequency. We may conclude that in reducing migraine attack frequency, older drugs are more effective though newer one also seems to be promising.