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Botulinum Toxin Type A and Divalproex Sodium for Prophylactic Treatment of Episodic or Chronic Migraine
Blumenfeld AM, Schim JD, Chippendale TJ.
Posted: May 2008  
Headache  2008;48:210-220

Objective:   To compare the efficacy and safety of botulinum toxin type A and divalproex sodium as prophylaxis in reducing disability and impact associated with migraine.

Background:   There is a need for effective, well-tolerated prophylactic treatment of migraine.

Design/Methods:   This was a randomized, double-blind, single-center prospective study with 59 patients. Patients were evaluated at 1,3,6, and 9 months.

Results:   Both treatments showed significant improvements in migraine disability scores and reductions in headache days and headache index. A trend to decreased headache severity was observed with botulinum toxin type A. A greater percentage of divalproex sodium patients reported adverse events possibly related to treatment and discontinued because of adverse events.

Conclusions:   Both botulinum toxin type A and divalproex sodium significantly reduced disability associated with migraine; botulinum toxin type A had a favorable tolerability profile compared with divalproex sodium.