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Medications such as amitriptyline, venlafaxine, atenolol, and nadolol are probably effective but should be second-line therapy. There is limited evidence for nebivolol, bisoprolol, pindolol, 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. This double-blind, randomized, placebo-controlled, multicenter study in patients with migraine (with or without aura) was conducted to determine the efficacy and safety of gabapentin in migraine prophylaxis. 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. 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. 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 Gabapentin is an effective prophylactic agent for patients with migraine. In addition, gabapentin appears generally well tolerated with mild to moderate somnolence and dizziness. 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 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 To describe and assess the evidence from controlled trials on the efficacy and tolerability of gabapentin/gabapentin enacarbil or pregabalin for preventing migraine attacks in adult patients with episodic migraine. Conclusion.—Gabapentin is an effective prophylactic agent for patients with migraine. In addition, gabapen-tin appears generally well tolerated with mild to moderate somnolence and dizziness. 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 Guidance from NICE and SIGN agrees that gabapentin should not be considered as a prophylactic treatment for migraine [NICE, 2021; SIGN, 2023]. Gabapentin is no better than placebo for prophylactic treatment of migraine in adults, is commonly associated with adverse events and there is an increased risk of addiction . Prophylactic migraine treatment should be considered in patients with more than three monthly episodes or at least eight headache days in one month. [4] [5] Patients with severe debilitating headaches despite appropriate acute treatment or those who are intolerant or have contraindications to acute therapy. 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. 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. 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 Recent reviews, including a Cochrane review,28 conclude that further evaluation of gabapentin in migraine prophylaxis is warranted in order to inform clinical practice. Silberstein and colleagues 29 conducted a randomized double-blind placebo-controlled trial of gabapentin enacarbil, a transported prodrug of gabapentin that provides sustained 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 Tronvik E, Stovner LJ, Helde G, Sand T, Bovim G. Prophylactic treatment of migraine with an angiotensin II receptor blocker: a randomized controlled trial. JAMA. 2003;289(1):65–69. doi: 10.1001/jama.289.1.65. [Google Scholar] 20. Mathew NT, Rapoport A, Saper J, et al. Efficacy of gabapentin in migraine prophylaxis.
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