Antiseizure medications for cluster headaches

Antiseizure medicines are sometimes used to prevent the frequency or recurrence of cluster headaches, which are cycles of painful, one-sided headaches. Antiseizure medicines most often prescribed for cluster headaches include divalproex sodium and valproic acid.

Another antiseizure medicine currently being evaluated for the prevention of cluster headaches is topiramate (Topamax). Preliminary studies show that it also may be an effective medicine to prevent cluster headaches, but more research is needed.¹

It is not clear exactly how antiseizure medicines work to reduce cluster headaches or migraines. Antiseizure medicines are usually taken daily in small doses and then gradually increased until your symptoms subside or the side effects become intolerable. Initial studies show that about half of those who have occasional and chronic cluster headaches get relief when they use these medicines to prevent cluster headaches.²

Common side effects include:

• Weight gain.
• Drowsiness.
• Fatigue or lethargy.
• Headaches.
• Nausea.
• Orthostatic hypotension (low blood pressure upon standing).

The U.S. Food and Drug Administration (FDA) has issued a warning on antiseizure medicines and the risk of suicide and suicidal thoughts. The FDA does not recommend that people stop using these medicines. Instead, people who take antiseizure medicine should be watched closely for warning signs of suicide. People who take antiseizure medicine and who are worried about this side effect should talk to a doctor.

Citations

1. McGeeney BE (2003). Topiramate in the treatment of cluster headaches. Current Pain and Headache Reports, 7(2): 135–138.

2. Rozen TD (2002). New treatments in cluster headache. Current Neurology and Neuroscience Reports, 2(2): 114–121.