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Antiseizure Medicines for Cluster Headaches

Antiseizure medicines are sometimes used to prevent the frequency or recurrence of cluster headaches, which are cycles of painful, one-sided headaches. Antiseizure medicines most often prescribed for cluster headaches include topiramate and valproate. These medicines are usually tried with another medicine to prevent cluster headaches.

It is not clear exactly how antiseizure medicines work to reduce cluster headaches or migraines. Antiseizure medicines are usually taken daily in small doses and then gradually increased until your symptoms subside or the side effects become intolerable.

Common side effects include:

  • Weight gain.
  • Drowsiness.
  • Fatigue or lethargy.
  • Headaches.
  • Nausea.
  • Orthostatic hypotension (low blood pressure upon standing).

Do not use valproate if you are pregnant, breast-feeding, or planning to get pregnant. If you need to use this medicine, talk to your doctor about how you can prevent pregnancy.

Women who use topiramate during pregnancy have a slightly higher chance of having a baby with birth defects. If you are pregnant or planning to get pregnant, you and your doctor must weigh the risks of using this medicine against the risks of not treating your condition.

The U.S. Food and Drug Administration (FDA) has issued a warning on antiseizure medicines and the risk of suicide and suicidal thoughts. The FDA does not recommend that people stop using these medicines. Instead, people who take antiseizure medicine should be watched closely for warning signs of suicide. People who take antiseizure medicine and who are worried about this side effect should talk to a doctor.

By Healthwise Staff
Anne C. Poinier, MD - Internal Medicine
Colin Chalk, MD, CM, FRCPC - Neurology
Last Revised July 29, 2013

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