Introduction: Migraine headache is a significant health problem affecting patients’ both physiological and psychological well-being and quality of life. It is to be kept in mind that although there are several trials that support the efficacy of various drugs for migraine prophylaxis against placebo, there is limited evidence addressing the comparative efficacy study of these drugs. We conducted a prospective study in a tertiary care teaching hospital to facilitate and evaluate comparison between drugs for migraine prophylaxis. Material and Methods: A prospective observational study was conducted at a tertiary hospital (A medical college & hospital in Kolkata) in Eastern India. Study enrolled patients diagnosed with migraine (according to ICHD-3 criteria). Mono-therapies were done with Amitriptyline: Flunarizine: Propranolol: Topiramate: Valproate as treatment of migraine prophylaxis divided in 5 groups. Included patients were evaluated for Visual Analogue Scale, Ordinal Scale and Predefined Questionnaire (with the use of visual analogue scale). Result and Analysis: The statistical analysis was done using descriptive statistics with use of comparative tables. The collected data were entered into a Microsoft Excel spreadsheet and then analysed by Wilcoxon Signed Rank Test and Kruskal Wallis (Post hoc) Test (Dunn’s). Initially, baseline data was compared for the five groups.Test and it yielded no significant difference in values. Then intra-group comparison for before and after each group of prophylactics was done. Intergroup comparison was done by using Kruskal Wallis (post hoc) test again and result was noted. And using the results, the various groups of drugs were arranged according to their median ranks. Conclusion: All the 5 groups had comparable reduction in headache burden and number of headache days per month and there was no significant difference in the mean scores between the groups indicating similar efficacy of the drugs used in the study. Available AEDs to prophylactically treat migraine are few but of robust clinical efficacy. Special care needs to be exerted with respect to their side effects.

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