The effect of gender differences on the use of valproic acid for migraine prophylaxis

Abstract

Aim: The efficacy of the drugs used for migraine prophylaxis remains unclear. At our headache polyclinic, when we observed the difference in prophylactic response especially in valproic acid (VA) treatment between genders, the response of male was found to be better than that of females so we wanted to document this difference by collecting data retrospectively Material and Method: Forty-six chronic migraine without aura patients with VA who were enrolled in our headache outpatient clinic between 2015-2018 were included in the study (29 male, 17 female). In these patients, after VA the frequency of montly attacks between sexes, changes in visual analogue scale (VAS) scores, single VA prophylaxis and the addition of a second prophylaxis drug were evaluated. Results: None of the men needed an additional second drug while 11 of 17 women needed the addition of a second drug. There was no gender difference in monthly attack frequency before treatment, whereas monthly attack frequency after treatment with VA was found to be significantly lower in men (before treatment; female 20.9±11.3 male 17.7±11.5, p>0.05) (after treatment; male 1.2±5.5 female 12.0±12.2, p<0.05). There was no difference between sexes in the pre-treatment VAS scores, but the VAS score was significantly lower in men after treatment with VA (before treatment; female 7.8±0.8 male 8.1±1.2, p>0.05)(after treatment; female 4.4±2.8 male 2.3±2.8, p<0.05). 75.9% of men had no post-treatment migraine attacks, while this rate was 5.9% in women (p<0.05). The dose range of VA treatment wasn't found to be different between genders. Conclusion: Better response of men with migraine to valproic acid treatment is important in clinical practice, and the reason for this situation may be clarified with further studies.