Anticonvulsants – Antiepileptic Drugs

Anticonvulsants, which are also called antiepileptic drugs, are prescribed to treat several medical problems from epilepsy and other seizure disorders to bipolar disorder. Researchers believe migraine and epilepsy are related since they share some common elements of brain chemistry. Additionally, more patients with epilepsy than the general population suffer from migraine, as well as the reverse.1

The first anticonvulsant drug was approved in the U.S. in 1946. Since then others have come onto the market. The drugs have become popular for treating neurological issues as well as psychiatric disorders.

There are several drugs in the anticonvulsant class, but only a few are approved to prevent migraine. Some of the medications in this class were discovered and approved almost a half-century ago and are considered the “first generation” in this class. Other, newer anticonvulsants, approved in the past two decades, are considered “second generation.”

Several anticonvulsants are available as generics.

How do anticonvulsants work?

As with many drugs on the market, doctors aren’t exactly certain how anticonvulsants help prevent migraine or reduce the number of attacks. Researchers think that overly excitable nerves in the brain may be partly responsible for causing both epilepsy and migraine.1

Anticonvulsant drugs are thought to have an impact on neurotransmitters, which are certain brain and nervous system chemicals. These medications may also block certain electrical signals in nerve and brain cells. Doctors typically recommend trying migraine prevention medications for two to six months to determine if it will work to prevent migraine.

What are some common anticonvulsants that prevent migraine?

There are several different anticonvulsants available by prescription, however only the following are approved by the U.S. Food and Drug Administration for preventing migraine. Some have been studied and have been shown not to work in migraine prevention.

  • Sodium valproate (also known as valproic acid or divalproex sodium) – two common brands include Depakote®, and Depakote® ER
  • Topiramate — two common brands include Topamax® and Trokendi®-XR2

What are some side effects of anticonvulsants?

More than half of people who take anticonvulsant drugs report experiencing at least one side effect. The most common side effects are:

  • Dizziness
  • Nausea
  • Sleepiness
  • Diarrhea
  • Weight loss

Some people also experience:

  • Swelling in the feet and hands
  • Weight gain
  • Blurry vision
  • Trouble concentrating
  • Lapses in memory
  • Hair loss3

What else should I know about anticonvulsants for migraine?

Women taking oral contraceptives should be aware that some anticonvulsant medications reduce the effectiveness of the contraceptives. Before starting any new medication, if you are of childbearing potential, you should discuss contraceptive options as well as the potential impact on pregnancy with your physician.

Some migraine prevention treatments cause harm to developing fetuses. In addition, some of these medications can cause serious damage to the liver or pancreas.3

Written by: Sara Finkelstein | Last reviewed: June 2018.
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