Rejection and acceptance of possible side effects of migraine prophylactic drugs

Successful prophylactic therapy might require not only efficacy but meeting patients' expectations about the potential side effects of the preventative drug selected. Prior to prescribing prophylactic drugs to prophylaxis-naive migraine patients, we aimed to quantify the acceptance or rejection of some of the possible adverse events associated with migraine prophylactic drugs.

A total of 203 prophylactic-naive migraine/chronic migraine patients, 17 (8.4%) male, 186 (91.6%) female, aged 19 to 65 years were serially selected and asked to answer bidirectional visual numerical scales designed for this purpose, with 1 scale for each side effect. The question posed was: "How much would you accept or reject the following side effects to get rid of your migraine headaches?" The side effects listed were dry mouth, epigastric burning, low energy, tingling, somnolence, depression, tremor, insomnia, memory loss, sluggishness, weight gain, and weight loss.

The most rejected possible side effects were weight gain, memory loss, and depression. Weight loss was better accepted by patients with a higher body mass. In general, there was a higher acceptance of side effects for patients taking more than 10 symptomatic medications a month, especially for loss of energy and somnolence. Older patients lacked an acceptance of tremor.

Our findings reinforce and quantify findings similar to those in the literature, and provide new data regarding the preference determinants for prophylactic medication.