TY - JOUR
T1 - Therapeutic efficacy of nimodipine and topiramate on migraine and vestibular migraine; A prospective multicenter open-label study
AU - Choi, Seo Young
AU - Oh, Sun Young
AU - Kim, Hyun Ah
AU - Park, Ji Yun
AU - Choi, Jae Hwan
AU - Oh, Eun Hye
AU - Choi, Jeong Yoon
AU - Jeong, Seong Hae
AU - Lee, Seung Han
AU - Kim, Jae Myung
AU - Kim, Sang Ho
AU - Kim, Hyo Jung
AU - Choi, Kwang Dong
AU - Kim, Ji Soo
N1 - Publisher Copyright:
© 2026 Choi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2026/3
Y1 - 2026/3
N2 - Background Although new preventive treatments for migraine have emerged, it remains essential to validate the efficacy of established drugs to ensure broader therapeutic options for migraine and, in particular, for vestibular migraine where clinical evidence is more limited. This study aimed to assess the therapeutic effectiveness of nimodipine, an L-type calcium channel blocker, in patients with migraine and vestibular migraine, with reference to outcomes observed with topiramate. Methods Using a prospective open-label study involving nine referral-based university hospitals in South Korea, we recruited 850 patients (81% women, mean age ± SD = 41 ± 12) with migraine, including 255 with vestibular migraine. The primary outcome was the change in headache days over three months. The secondary outcomes included changes in pain rating scale, Migraine Disability Assessment Scale (MIDAS) and Headache Impact Test-6 (HIT-6). The outcomes of vestibular migraine included dizziness days and intensity, Dizziness Handicap Inventory, and UCLA-Dizziness Questionnaire. Results Of the 850 patients, 465 (55%) completed three months of evaluation (205 in the nimodipine group, 160 in the topiramate group, and 100 in the combination group). All groups showed a significant reduction in the headache days (1.2–2 days/week, p<0.001) without inter-group differences (p=0.865). The topiramate group showed greater improvements in MIDAS and HIT-6 scores than the nimodipine (p=0.004) and combination groups (p=0.040). For vestibular migraine (n=131), all groups improved in headache and dizziness outcomes (p<0.001) without inter-group differences. Adverse events leading to study discontinuation were observed only in 14 (2%) patients without a difference among the groups. Conclusion Nimodipine was associated with improvements in headache-related outcomes in migraine and in both headache- and dizziness-related outcomes in vestibular migraine. Given the observed improvements and favorable tolerability, nimodipine may be a valuable treatment option for migraine and vestibular migrain.
AB - Background Although new preventive treatments for migraine have emerged, it remains essential to validate the efficacy of established drugs to ensure broader therapeutic options for migraine and, in particular, for vestibular migraine where clinical evidence is more limited. This study aimed to assess the therapeutic effectiveness of nimodipine, an L-type calcium channel blocker, in patients with migraine and vestibular migraine, with reference to outcomes observed with topiramate. Methods Using a prospective open-label study involving nine referral-based university hospitals in South Korea, we recruited 850 patients (81% women, mean age ± SD = 41 ± 12) with migraine, including 255 with vestibular migraine. The primary outcome was the change in headache days over three months. The secondary outcomes included changes in pain rating scale, Migraine Disability Assessment Scale (MIDAS) and Headache Impact Test-6 (HIT-6). The outcomes of vestibular migraine included dizziness days and intensity, Dizziness Handicap Inventory, and UCLA-Dizziness Questionnaire. Results Of the 850 patients, 465 (55%) completed three months of evaluation (205 in the nimodipine group, 160 in the topiramate group, and 100 in the combination group). All groups showed a significant reduction in the headache days (1.2–2 days/week, p<0.001) without inter-group differences (p=0.865). The topiramate group showed greater improvements in MIDAS and HIT-6 scores than the nimodipine (p=0.004) and combination groups (p=0.040). For vestibular migraine (n=131), all groups improved in headache and dizziness outcomes (p<0.001) without inter-group differences. Adverse events leading to study discontinuation were observed only in 14 (2%) patients without a difference among the groups. Conclusion Nimodipine was associated with improvements in headache-related outcomes in migraine and in both headache- and dizziness-related outcomes in vestibular migraine. Given the observed improvements and favorable tolerability, nimodipine may be a valuable treatment option for migraine and vestibular migrain.
UR - https://www.scopus.com/pages/publications/105033195748
U2 - 10.1371/journal.pone.0344948
DO - 10.1371/journal.pone.0344948
M3 - Journal article
C2 - 41855149
AN - SCOPUS:105033195748
SN - 1932-6203
VL - 21
JO - PLoS ONE
JF - PLoS ONE
IS - 3 March
M1 - e0344948
ER -