Efficacy of lamotrigine in the treatment of migraine with aura: A retrospective observational case series
Abstract
Lamotrigine is sometimes identified as a useful preventive in migraine with aura. We evaluated our experience with the efficacy and tolerability of lamotrigine in the treatment of migraine with aura.
A service evaluation of responses to lamotrigine at a tertiary headache clinic using clinic letters from January 2015 to January 2025 was performed. Patients with a diagnosis of migraine with aura in keeping with International Classification of Headache Disorders 3rd edition (ICHD-3) criteria who had received lamotrigine were included in the analysis. Treatment effect was defined as any patient-reported improvement in migraine headache frequency or severity.
Fifty-two patients were identified, of whom 83% were women. The median age was 47 years (35–56). The majority of patients had chronic migraine (90%). Visual aura was the most common subtype of aura (77%). Fourteen (27%) patients reported side effects and 12 (23%) ceased lamotrigine due to these side effects. One patient of 24 who had at least 100 mg/day (4%) reported treatment efficacy specifically for their migraine headache.
In a tertiary headache cohort, lamotrigine demonstrated limited effectiveness in preventing migraine with aura and was associated with a notable rate of adverse effects that led to treatment discontinuation.
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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