The Effect of Topiramate and Propranolol on Serum Calcitonin Gene Related Peptide (CGRP) Level on Migraine Patients

Abstract Background Migraine is a common multi-factorial, neurovascular disorder with major individual and social effect. Although the mechanisms are unknown, activation of the TNC leads to peripheral release of calcitonin gene-related protein (CGRP), most likely from C-fibers. Topiramate is `a first-choice oral medication for migraine prophylaxis. It is one of the most frequently prescribed preventative anti-migraine drugs. Other first-line, non-specific preventatives include β-blockers, flunarizine, and amitriptyline. All these medications are inexpensive treatment options, which are effective in a large population of patients. Objective to study the effect of topiramate and propranolol on serum calcitonin gene related peptide (CGRP) level in peripheral blood in migraine in Headache outpatient clinic and neurology department at Ain Shams University hospital. Methods it’s a cross-sectional time interval study conducted between October 2022 to April 2023. we conducted our study on 50 patients at our outpatient headache clinic were diagnosed as migraine according to ICH-3rd edition. blood sampling was obtained from all 50 patients for estimation of CGRP in peripheral blood before receiving any medication then all patients received propranolol 40mg and topiramate 25 mg after two months blood sample obtained for estimation of cgrp. Results Highly statistical significant (p-value < 0.001) decreased CGRP (after medication) (mean = 141.1 ± 62.5, range = 53 – 320) when compared with CGRP (before medication) (mean = 190.3 ± 71.7, range = 92 – 395) in all studied patients Conclusion both topiramate and propranolol show significant decrease in serum calcitonin gene related peptide in migraine patients.