Migraine Prophylaxis With Clopidogrel Trial
Migraine Prophylaxis With Clopidogrel Trial
The underlying mechanisms of association between the right-to-left shunts (RLS) and migraine
 may concern with platelet aggregation and paradoxical embolization. The aim of the study is
 to evaluate the prophylactic effectiveness of clopidogrel for migraineurs with RLS.
Many studies have shown an increased prevalence of right-to-left shunts in migraineurs. The
 underlying mechanisms of association between the right-to-left shunts (RLS) and migraine may
 concern with platelet aggregation and paradoxical embolization. In the present study,
 migraineurs without taking prophylactic medicines regularly will be given only clopidogrel 75
 mg daily for three months. Migraineurs who are unresponsive to at least two commonly applied
 preventive medications, clopidogrel 75 mg daily will be added to his/her existing
 prophylactic migraine regimen for three months. Patients will be followed up at the third
 month and the sixth month for headache frequency, attack duration of headache, migraine
 disability assessment scale（MIDAS）scores, headache impact test（HIT-6）scores and visual
 analogue scale（VAS）scores. Investigators will evaluate the changes of these measurements
 between baseline and the follow-up time. The aim of the study is to evaluate the prophylactic
 effectiveness of clopidogrel for migraineurs with RLS.
Inclusion Criteria:

 -  migraine with or without aura diagnosed by a neurologist according to the criteria of
 the International Headache Society (3nd edition)

 -  experience a minimum of two migraine attacks per month in a 3-month baseline phase

 -  without regular use of prophylactic treatments or unresponsive to two and more
 commonly applied preventive medications

 -  the presence of RLS confirmed by contrast-enhanced transcranial Doppler

 -  no positive findings in cranial CT and MRI

 Exclusion Criteria:

 -  other types of headaches

 -  systemic chronic diseases, cerebrovascular disease, abnormal platelet or liver
 function

 -  history of head injury

 -  other contraindications to clopidogrel treatment