%0 Journal Article
%T Triptans, gepants, lasmiditan, and valproate for migraine: A 24-week prospective cohort study in Iraq
%A Deleen Abd AL Wahab Hasoon
%A Lubab Tareq Nafea
%A Shaymaa Hasan Abbas
%J Journal of Advanced Pharmacy Education and Research
%@ 2249-3379
%D 2026
%V 16
%N 3
%R 10.51847/3yH8IKuTMV
%P 188-198
%X Prospective real-world data comparing all major migraine drug classes are scarce in low- and middle-income countries; Iraq offers an opportune setting given expanding access to gepants and lasmiditan. To compare 24-week efficacy, tolerability, and medication overuse headache (MOH) risk across triptans, gepants, lasmiditan, and valproate in Iraqi migraineurs, and to identify independent predictors of optimal response. This prospective cohort study (February–August 2024) enrolled 247 patients at four Baghdad tertiary headache clinics. Four primary drug groups (triptans n=110, gepants n=46, lasmiditan n=38, valproate n=35; N=229) were compared by ANOVA; a smaller simple-analgesics cohort (n=18) was analysed descriptively. Monthly migraine days (MMD), visual analogue scale (VAS), and HIT-6 were assessed at baseline, 12, and 24 weeks. Ethical approval was obtained (Approval No. 238); retrospective ISRCTN registration is in progress. At 24 weeks, gepants achieved the lowest residual MMD (3.9±2.4 days/month), VAS (3.8±1.4), and HIT-6 (47.8±6.8), significantly better than triptans (P
%U https://japer.in/article/triptans-gepants-lasmiditan-and-valproate-for-migraine-a-24-week-prospective-cohort-study-in-ira-wfr1b4cph0qn9l3