Anticonvulsant drug Trileptal (oxcarbazepine) is not an effective migraine preventive even though preliminary data indicated it might be. In the 15-week study, 85 patients received Trileptal and 85 received a placebo. There was no difference in the number of migraine attacks for the two groups.
Unlike other epilepsy drugs that are successful for migraine prevention, Trileptal does not regulate a neurotransmitter involved in the headaches.
“Since some antiepileptics are useful against migraine
headaches, it would be reasonable to assume that Trileptal would work, too. This is an example of what is necessary to prove the presence or absence of benefit,” Molofsky said.
The three epilepsy drugs that have been shown to prevent
migraines, topiramate, divalproex and gabapentin, do so through several mechanisms. One mechanism is the regulation of the neurotransmitter called GABA. However, oxcarbazepine appears not to affect GABA activity. It is possible that epilepsy drugs need to regulate GABA to prevent migraine, Silberstein noted.