Comparison of single dose sodium valproate (Depakine) versus Dexamethasone Intravenously for treatment of acute migraine headache

Background: Migraine headache is a chronic and disabling primary headache in adult. Oral sodium valproate was approved as prophylaxis therapy for this disorder but the effectiveness and tolerability of intravenous valproate as abortive therapy is still not clear.
Methods: We conducted a double-blind, randomized clinical trial for 90 patients between the ages of 18 to 65 years who were referred to emergency department with moderate to severe acute migraine headache. Patients were randomized to receive either dexamethasone or valproate sodium intravenously. Our primary outcome measure was the pain relief after half an hour, 1, 3, 6-hour after injection of drugs. For data analysis, Pearson chi square and T test were employed.
Results: Of the 90 patients, eighty patients were investigated. The percentage of headache improvement at 0.5 hour after treatment was 55 and 67.5% in valproate and dexamethasone group, respectively. The severity of pain with VAS score pre-treatment and half an hour post-treatment had been shown as 9.05±0.90 and 3.8±3.09 at Valproate group and 8.92±0.79 and 3.10±2.73 at Dexamethasone group, respectively. There was no significant different between the two groups.
Conclusion: This RCT trial showed that rapid intravenous injection of 400 mg Valproate (single dose) has similar effects with Dexamethasone in the improvement of acute migraine headache.