Migraine aura sufferers may benefit from epilepsy drug, Swedish study suggests
Researchers at Lund University found that 85% of patients with aura-dominant migraine saw at least a 50% reduction in monthly aura days after taking lamotrigine. The results, published in Frontiers in Neurology, need confirmation in controlled trials. The drug targets cortical spreading depolarization, a wave of altered nerve activity thought to underlie aura.
The study tracked 81 patients with frequent or severe aura symptoms. Monthly aura days fell from an average of 6.9 to 1.4, an approximately 80% reduction, with 85% of participants achieving at least a 50% decrease. Lamotrigine stabilizes nerve cell electrical activity by acting on sodium and potassium channels and reducing glutamate release, mechanisms that may suppress cortical spreading depolarization.
The drug is already approved for epilepsy and bipolar disorder but not for migraine. Earlier lamotrigine trials produced inconsistent results, making these outcomes notable. Roughly 50,000 Swedes have aura-dominant migraine, and aura carries a modestly elevated ischemic stroke risk when combined with vascular risk factors. Controlled trials remain necessary before clinical adoption can be considered.
If confirmed in controlled trials, this could offer the first targeted treatment for aura-dominant migraine, a group of roughly 50,000 people in Sweden alone who currently lack specific options. Patients may experience reduced disability, fewer sick days, and lower healthcare costs. However, since lamotrigine is not approved for migraine, off-label prescribing would be required, and clinicians may weigh potential side effects carefully. The findings could also shift research attention toward shared mechanisms between epilepsy and migraine.