Efficacy Comparison of Nortriptyline and Topiramate used as monotherapy and in combination for Migraine prophylaxis

Muhammad Imtiaz, Neha Tariq, Muhammad Saad Ikram,, Zahid Bashir


Background: Migraine headache is one of the most common and disabling disorders of nervous system that impairs the quality of life. Combination of nortriptyline and topiramate can be effective in prophylaxis of migraine.

Objective: Our aim was to compare the efficacy of nortriptyline and topiramate used as monotherapy and in combination in terms of reduction of number of attacks and duration of pain of migraine.

Subjects and Methods: This cross-sectional study was carried out at out  patient clinic, Neurology department, Sir Ganga Ram hospital Lahore from August 2019 to March 2020. Data was collected from 120 patients(15-50 years of age ) who fulfilled the diagnostic criteria of migraine using non-probability consecutive sampling technique. They were divided into three groups of 40 patients each. Group A received nortriptyline, group B topiramate and group C combination of both drugs.

Results: In group A after three months 16 patients(40%), and after 6 months 24 patients (60%) , in group B after three months 14 patients (35%) and after 6 months 22 patients(55%) and in group C at three months  24 patients(60%),at 6 months 32 patients(80%) have 50% or more reduction in number of migraine attacks per month. Similarly there was significant reduction in duration of pain in group C as compared to group A and B.

Conclusion: The efficacy of nortriptyline and topiramate in combination is significantly greater than used as monotherapy in terms of reduction of number of migraine attacks and duration of pain.

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