The efficacy and safety of valproate medications for migraine in adults: a meta-analysis.

OBJECTIVE Many parallel-group studies of migraine prophylaxis using valproate medications were reported in recent decades. This meta-analysis assessed the efficacy and safety of valproate medications for migraine prophylaxis in adults. MATERIALS AND METHODS Searches were conducted in five databases: PubMed, Wiley, ScienceDirect, Web of Science, and the Cochrane Library. The data were acquired through December 31, 2018. Two independent authors searched for controlled clinical trials involving the use of valproate medications in migraine prophylaxis. Studies that met the inclusion criteria were assessed, and their methodological quality was examined. RESULTS Seven placebo-controlled studies (782 participants) and seven controlled trials against active comparators (554 participants) were included in the final analysis. The active treatment of valproate medications was significantly superior to placebo (OR, 4.02; 95% CI 2.17-7.44; I2 = 66%). Compared with the other active comparators, there were no significant differences between treatments in the proportion of responders. CONCLUSIONS Valproate medications were more effective than placebo in migraine prevention, with statistically significant differences. Both valproate and the other active comparators were well-tolerated, and no significant difference was noted in efficacy and safety for the prophylaxis of migraine.