Kingston

Researchers are comparing three oral medicationsatogepant, propranolol, and topiramateto prevent migraine in adults. This study aims to find out if one medication works better or is better tolerated than the others for migraine prevention. It is a randomized clinical trial focusing on adults aged 18 to 70 with different types of migraine, including those with or without aura and chronic migraine. Participants will first keep a daily headache diary for four weeks to track migraine patterns. After this period, eligible participants will be randomly assigned to take one of the three study medications daily for twelve weeks. The dosages are up to 60 mg for atogepant, 160 mg for propranolol, and 100 mg for topiramate each day. Research visits will occur at the start, after four weeks for randomization, and post-randomization visits at weeks four, eight, twelve, twenty-four, and forty-eight. Throughout the study, participants will provide headache diary data during the first 16 weeks and attend scheduled research visits. Researchers will measure the main outcome by looking at the proportion of participants who respond to treatment with a 50% or greater reduction in moderate to severe headache days during weeks 9-12 compared to before treatment. They will also assess quality of life related to migraines and monitor any medication-related side effects over the 12-week treatment phase.