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The effect of gabapentin to increase GABA concentrations in the brain may provide a possible explanation for its mechanism of action in migraine prophylaxis. Increases in GABA may suppress the abnormal cortical activities that underlie migraine aura and reduce central neuronal hyperexcitability. Gabapentin is not a first-line drug for treating migraine, so your provider won’t prescribe it to you unless you’ve tried other preventive medications like antidepressants, beta-blockers, and/or migraine-specific preventative drugs that block calcitonin gene-related peptide (CGRP), including Aimovig, Ajovy, Vyepti, Nurtec, Qulipta, and There is a wide array of options for migraine prophylaxis; many of the available drugs are clearly proven to be effective and yet are underused in Australia. “New” drugs which are gaining favour for migraine prophylaxis include topiramate, candesartan, gabapentin and botulinum toxin. Does gabapentin (Neurontin) help prevent episodic migraine? Evidence-Based Answer Gabapentin does not decrease the frequency of migraine headaches and is not recommended for prophylactic Objective While there are several trials that support the efficacy of various drugs for migraine prophylaxis against placebo, there is limited evidence addressing the comparative safety and efficacy of these drugs. We conducted a systematic review and network meta-analysis to facilitate comparison between drugs for migraine prophylaxis. Methods We searched MEDLINE, EMBASE, CENTRAL, and Also, gabapentin reduced the headache frequency by 50% or greater in 45% patients compared with only 16% patients on placebo. Randomized, double-blind, placebo-controlled clinical study 10 of gabapentin enacarbil for migraine prophylaxis concluded that gabapentin was not significantly superior to placebo for migraine prophylaxis. Gabapentin shows to have an effective therapeutic action in the prophylactic treatment of migraine. Our observations indicate that gabapentin is well tolerated by patients and that reduces headache frequency and use of symptomatic drugs in both groups. Objective.—To compare gabapentin with placebo for use as a prophylactic agent in patients with migraine (with or without aura). Study Design and Treatment.—After screening, a 4-week, single-blind, placebo baseline period was followed by a 12-week, double-blind, treatment period. significant effect of gabapentin compared with placebo for migraine prophylaxis. In comparison with other widely used migraine preventive drugs, the estimated effect size for gabapentin not only fails to reach statistical significance, but also has a much lower magnitude of effect. The objective of our study was to assess the efficacy and safety of gabapentin in the prophylaxis of migraine in patients refractory to other prophylactic treatments. The study included 67 migraine patients, 55 women and 12 men; 52 patients completed this prospective, open-label study. Gabapentin or pregabalin for the prophylaxis of episodic migraine in adults. Cochrane Database Syst Rev. 2013(6):CD010609. Xu XM, Liu Y, Dong MX, Zou DZ, Wei YD. The pooled evidence derived from trials of gabapentin suggests that it is not efficacious for the prophylaxis of episodic migraine in adults. Since adverse events were common among the gabapentin-treated patients, it is advocated that gabapentin should not be used in routine clinical practice. Gabapentin Gabapentin’s mode of action in migraine is unclear (66). It interacts with the α 2δ-subunit of the calcium channel and increases the concentration and probably the syn-thesis of brain γ-aminobutyric acid (GABA). Gabapentin binds to gabapentin-binding protein—a novel, membrane-associated protein in the outer layers of the Studies were required to be prospective, controlled trials of gabapentin/gabapentin enacarbil or pregabalin taken regularly to prevent the occurrence of migraine attacks, to improve migraine‐related quality of life, or both. Two review authors independently selected studies and extracted data. Gabapentin is an effective prophylactic agent for patients with migraine. In addition, gabapentin appears generally well tolerated with mild to moderate somnolence and dizziness. In 2022, a trial (Head-to-Head Study of Erenumab Against Topiramate in Patients with Episodic and Chronic Migraine [HERMES]) comparing erenumab and topiramate for the prevention of migraine was published. 38 The HER-MES study was a 24-week, randomized, double-blind, placebo-controlled trial conducted in adults (n = 777); most patients had GBP has some efficacy in migraine headache, but not sufficient evidence to suggest primary therapy. When primary headache treatments fail, a GBP trial may be considered in the individual patient. Gabapentin , Headache , Migraine , Chronic Daily Headache Do NOT offer gabapentin for migraine prophylaxis. Consider non-pharmacological therapies as an adjunct or alternative to pharmacological therapy depending on the specific clinical situation and the person’s preference, including: N-alpha-methyl histamine safety and efficacy in migraine prophylaxis: phase III study. Can J Neurol Sci. 2006;33(2):195–199. doi: 10.1017/s0317167100004960. [Google Scholar] 60. Brandes JL, Visser WH, Farmer MV, et al. Montelukast for migraine prophylaxis: a randomized, double-blind, placebo-controlled study. Recurrent migraines can be functionally disabling and can impair quality of life. After treating acute migraines, all migraine patients should be evaluated for preventive therapy. Preventive therapy aims to decrease the frequency, severity, and duration of migraine attacks.
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