Is Baclofen Effective for Prevention of Migraine?

Despite 20 years of interest in the possible role of gamma-aminobutyric acid (GABA) in the pathogenesis of migraine, sodium valproate, a GABA_A agonist, has only recently been recognized as a preventive agent for migraine. A related drug, baclofen, which is widely used for the treatment of spasticity and neuropathic pain, is a GABA_B analog that crosses the blood-brain barrier. Intrathecal baclofen may reduce central pain in patients with spinal lesions or after cerebral strokes. To study a possible role for baclofen in the prophylaxis of migraine, 54 patients who experienced four to eight moderate-to-severe attacks of migraine per month were enrolled in a 12-week, open-label pilot study. After a four-week running baseline period, patients re…