Comparative Analysis of Topiramate with Amitriptyline in Prophylaxis of Migraine without Aura Among Outpatients Visiting Tertiary Care Hospital

Abstract

Objective: To ascertain the better drug between Topiramate and Amitriptyline for the prevention of migraines without aura
among patients of the adult age group visiting the tertiary care hospital.

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Combined Military Hospital, Malir Cantt Pakistan, from May to Oct 2022.

Methodology: Two hundred seventy individuals visiting the Outpatient Department of the tertiary care hospital were
included in the study who were suffering from migraines without aura. They were randomly assigned to groups of 135 each,
which were to receive Topiramate and Amitriptyline, respectively. After informed consent, their treatment was started with
monthly follow-ups. Data was collected in the form of a questionnaire derived from the Migraine Disability Assessment
Questionnaire (MIDAS), Headache Impact Test (HIT-6) and Migraine Specific Quality of Life Questionnaire (MSQ 2.1), both at
the start of treatment and later at the end of the study.

Results: Two hundred seventy individuals were included in the study. It comprised 162(60%) females and 108(40%) males.
Their mean age was 36.51±9.77 years. There was a significant improvement in migraine symptoms among topiramate and
amitriptyline groups (p-value<0.001). There was no significant difference in the efficacy of Topiramate and Amitriptyline (pvalue=0.411)

Conclusion: There was no significant difference in the efficacy of Topiramate and Amitriptyline in the prevention therapy of
migraine.