Prophylactic Activity of Cyproheptadine and Bellergal on Migraine Headache

Background: A wide range of preventive medications for migraine attacks, with varying efficacy is currently in use, Studies comparing the efficacies of these drugs would be of value in the proper treatment of the disease. The present study compared the frequency, duration and intensity of migraine attacks during and following treatment with cyproheptadine (4 mg, twice daily) or Blellergal (belladonna 0, I mg, ergotamine 0,3 mg and phenobarbital 20 mg). Methods: 118 patients 15 to 45 year-old with migraine headaches were randomly allocated to groups I (n=36), II (n=40) and III (n=42) and treated during three consecutive phases of 45 days. In phase one all groups received two oral placebo tablets daily. In phase two, group I continued with placebo, groups II and III received cyproheptadine (4 mg, twice daily) and Bellergal (three tablets daily), and finally, in phase three all groups were treated with placebo, respectively, Results: Cyproheptadine and Bellergal treatments significantly reduced the frequency, duration and intensity of migraine attacks. These parameters remained low during phase three (placebo) in cyproheptadine treated patients as compared to those who only received placebo, But there was a rebound effect following discontinuation of Bellergal. Conclusion: Cyproheptadine and Bellergal seem to preventive migraine attacks. Cyproheptadine is a preferred choice because its effects were partially preserved following withdrawal.