Regular aerobic exercise worked just as well as relaxation

therapy or the antiepileptic drug topiramate in preventing

headaches, according to a Swedish study.

Previous studies had found that relaxation therapy and

topiramate are effective for migraine prevention, the investigators

note. Emma Varkey and colleagues from the Institute of

Neuroscience and Physiology at the University of Gothenburg

conducted the study. Varkey’s team randomly assigned 91

women to 1 of 3 regimens for 3 months: aerobic exercise on

a stationary bicycle (40 minutes 3 times per week), relaxation

therapy, or daily topiramate. The 91 women were between the

ages of 18 and 65. All had neurologist-diagnosed migraine.

All 3 treatments reduced the frequency of some women’s

migraine attacks. The primary efficacy variable showed a mean

reduction of 0.93 (95% confidence interval (CI) 0.31–1.54)

attacks in the exercise group, 0.83 (95% CI 0.22–1.45) attacks

in the relaxation group, and 0.97 (95% CI 0.36–1.58) attacks

in the topiramate group. No significant difference was observed

between the groups (p=0.95).

Varkey said she was surprised by the small between-group

differences. The only parameter in which topiramate was better

than exercise or relaxation was the reduction of pain intensity.

On the other hand, Varkey noted, the non-pharmacological

options were free from adverse events. In addition, the

exercise group increased oxygen intake. The researchers added,

“From a wider health-based perspective, it should be stressed

that patients with migraine are less physically active than the

general population, and that exercise has positive effects in

terms of general well-being and the prevention of disease.”

Varkey E, Cider A, Carlsson J, Linde M. Exercise as migraine prophylaxis: a randomized study using relaxation and topiramate as controls. Cephalagia.31(14):1428-1438.