Topiramate vs Divalproex Sodium in the Preventive Treatment of Migraine: A Prospective Real-World Study

This study compared topiramate (TPM) and divalproex sodium (DVP) for migraine prevention in a real-world setting over 12 months. It included 120 patients (104 women, 16 men, ages 18-68). TPM was prescribed to 69 patients and DVP to 51. After 3 months, 58% of TPM patients and 51% of DVP patients experienced a >50% reduction in headache frequency. Common side effects for TPM included weight loss (50%), paresthesia (48%), and cognitive disturbances (20%), while DVP patients reported weight gain, hair loss, and gastrointestinal symptoms (24% each). The study concluded that both TPM and DVP were effective and generally well-tolerated for migraine prophylaxis, despite its open-label nonrandomized design.