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Updated: May 14, 2026

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

Published on: June 2, 2014

Amitriptyline vs divalproate in migraine prophylaxis: a randomized controlled trial.

J Kalita¹, S K Bhoi, U K Misra

¹Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India. jayanteek@yahoo.com

Acta Neurologica Scandinavica

|February 15, 2013

Summary

Divalproate extended release (DVA-ER) showed superior migraine reduction at 3 months compared to amitriptyline (AMT). However, both treatments demonstrated equal long-term efficacy for migraine prophylaxis after 6 months.

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Area of Science:

Neurology
Pharmacology

Background:

Migraine is a common neurological disorder impacting millions globally.
Effective prophylactic treatments are crucial for managing migraine frequency and severity.

Purpose of the Study:

To compare the efficacy and safety of divalproate extended release (DVA-ER) versus amitriptyline (AMT) for migraine prophylaxis.
To evaluate key outcome measures including headache frequency, severity, and visual analogue scale (VAS) scores.

Main Methods:

A randomized controlled trial involving 300 migraineurs with frequent attacks (>4 monthly).
Participants were assigned to either DVA-ER or AMT groups.
Primary endpoints included >50% reduction in headache frequency, ≥1 grade improvement in severity, and >50% improvement in VAS score.

Main Results:

At 3 months, DVA-ER showed a significantly higher improvement in headache frequency (74.7% vs 62%, P=0.02) and VAS scores (80.7% vs 64%, P=0.005) compared to AMT.
At 6 months, no significant differences were observed between DVA-ER and AMT for headache frequency, VAS scores, or other outcome parameters.
Adverse event rates were similar, though DVA-ER was associated with more hair fall, menstrual irregularities, polycystic ovary syndrome, and weight gain.

Conclusions:

Divalproate extended release (DVA-ER) offers a more effective migraine prophylactic benefit at the 3-month mark compared to amitriptyline (AMT).
Both DVA-ER and AMT are equally effective for long-term migraine prophylaxis after 6 months of treatment.
While generally safe, DVA-ER carries specific side effect risks that warrant consideration.