Seizure medicine to prevent migraine headaches

Examples

Generic Name	Brand Name
divalproex sodium	Epival
topiramate	Topamax
valproic acid	Depakene

How It Works

Topiramate and divalproex sodium are seizure medicines that are typically used to control seizures in people who have epilepsy. These medications are also used to prevent migraine headaches and have been approved by Health Canada for this use.

Why It Is Used

These seizure medicines, when they are taken regularly, may help to prevent migraine headaches.

How Well It Works

One study showed that topiramate was effective at preventing migraines.¹ Divalproex sodium also works well to prevent migraine attacks.²

Side Effects

Common side effects of topiramate include:

• Fatigue.
• A prickling or tingling sensation in the hands and feet.
• Lack of coordination.
• Loss of appetite and weight loss.
• Inability to concentrate or speak clearly.

Topiramate has been linked in some people to a potentially life-threatening condition called metabolic acidosis, which happens when there is too much acid in the blood. Symptoms include fatigue, lack of appetite, and rapid breathing (hyperventilation). If left untreated, metabolic acidosis can lead to death.

Rarely, topiramate may cause serious side effects, such as:

• Glaucoma, which can lead to blindness.
• An inability to sweat, which can lead to life-threatening fever or heatstroke.

Side effects from divalproex sodium may include:

• Fatigue.
• Nausea.
• Tremor or shakiness.
• Hair loss.
• Weight gain.
• Headache pain that is different than pain from a migraine headache.

Uncommon but potentially life-threatening side effects of divalproex sodium include:

• Liver failure.
• Inflammation of the pancreas.
• Elevated levels of ammonia in the blood (hyperammonemia).

Antiseizure medicines may increase the risk of suicide and suicidal thoughts. It is not recommended 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.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Women who take seizure medicines need to talk with their doctors if they are considering becoming pregnant. Seizure medicines may harm a fetus.

For some people, topiramate may produce side effects or carry risks, including an increased risk of birth defects, that are not yet fully known. Report any unexpected side effects or problems to your doctor.

Topiramate may make birth control pills less effective. A woman who is taking topiramate may need to use another method of birth control to reduce her chances of becoming pregnant.

If you have had kidney stones, be sure to tell your doctor this before you take topiramate. Using topiramate may increase your risk of having kidney stones again.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Author:	Douglas Dana Monica Rhodes	Last Updated: August 21, 2007
Medical Review:	Anne C. Poinier, MD - Internal Medicine Colin Chalk, MD, CM, FRCPC - Neurology
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