Lund University Study Finds Lamotrigine Treats Migraine Aura

Lund University Study Details and Findings

Around 1.5 million people in Sweden suffer from migraines, a condition that limits work capacity and social participation while creating high societal costs through sick leave and healthcare needs. Women are affected three times as often as men, primarily due to hormonal factors. Up to a third of migraine sufferers experience an aura—a temporary neurological symptom that can trigger visual disturbances, vision loss, sensory changes, balance issues, and speech difficulties. For about 50,000 people in Sweden with aura-dominant migraine, aura serves as the most debilitating part of the disease, yet no established treatment specifically targets it. To address this gap, researchers at Lund University examined 81 patients who suffered from frequent or particularly troublesome migraine auras and treated them with lamotrigine. Sena Uzun, a doctoral student at Lund University, noted that among the patients included the number of days with aura fell on average from 6.9 to 1.4 days per month, representing a reduction of around 80 per cent. Furthermore, 85 percent of patients in this aura-dominant group achieved at least a 50 percent reduction in monthly aura days.

Mechanisms of Migraine Aura and Lamotrigine

Aura is widely linked to cortical spreading depolarisation (CSD), which is a slowly progressing wave of altered nerve cell activity across the cerebral cortex. Because epilepsy and migraine auras both involve temporary shifts in nerve cell activity, researchers sought to test if lamotrigine could prevent aura episodes. Gürdal Sahin, a researcher at Lund University and a neurology specialist at the Skåneuro private clinic, explained the drug’s action by stating that there are now several effective treatments for migraine, including new medicines that block the neurotransmitter CGRP, which plays a key role in migraine attacks. Lamotrigine itself is approved to treat epilepsy and bipolar disorder rather than migraines. The medication targets sodium and potassium channels to alter nerve cell electrical activity and decreases the release of glutamate and other neurotransmitters. These actions help curb excessive nerve cell excitability, which in theory stops CSD from emerging and spreading. Sahin also noted that while botulinum toxin and CGRP-blocking drugs help prevent chronic migraines, as there is no established treatment that specifically targets the aura itself, migraines with and without aura are often treated in a similar way, even though the aura appears to be partly based on mechanisms other than the headache itself.

Next Steps for Clinical Trials

While past studies on lamotrigine yielded mixed outcomes, the Lund University findings offer strong promise for patients coping with frequent auras. Investigators observed that a slower dose escalation correlated with fewer side effects, offering a practical detail for upcoming evaluations. Because migraine with aura also correlates with a slightly increased risk of ischaemic stroke—especially alongside other vascular risk factors—managing the condition remains vital. Because the recent investigation was retrospective and lacked a control group, researchers emphasize that the findings require formal confirmation. Sena Uzun stated that we are now proceeding with a national, randomised, double-blind, placebo-controlled trial of lamotrigine, adding that if successful, the drug could become a relatively inexpensive and well-established treatment option for a group of patients who currently have no treatment for the aura itself.