Lamotrigine prophylaxis is associated with reduced aura frequency in patients with burdensome migraine aura: a retrospective observational study
Abstract
Introduction: Migraine aura affects approximately one-third of migraine patients. In some individuals, aura remains highly disabling due to the lack of effective, targeted treatment options. This study evaluates the effectiveness and long-term management of lamotrigine (LTG) in a clinical Cohort specifically burdened by frequent or severe aura.
Methods: A retrospective observational study was conducted at a neurology clinic in Lund, Sweden, including 81 patients treated between 2014 and 2022. The primary outcome was the proportion of patients achieving ≥50% reduction in monthly aura days (MADs) following LTG prophylaxis.
Results: A total of 81 patients were included in the study. A reduction in mean MADs from 6.9 ± 7.5 days/month to 1.4 ± 3.7 was observed following LTG initiation, with 79.7% mean reduction (p < 0.001). The overall response rate was 85.2%. The average dose of LTG was 149.6 mg ± 70.5. Twenty-nine patients had adverse events (AE), the most common type was skin changes, and 5 dropped out of the treatment due to AEs.
Discussion: The results indicate that LTG is associated with a reduction in aura frequency and is well-tolerated in patients whose migraine burden is dominated by the aura phase. LTG is a preventive option worthy of further evaluation in controlled trials.
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 81 participants or records.
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