Chinese researchers studying whether acupuncture helps migraine, have performed a meta-analysis of trials, to compare acupuncture with both botox and topiramate. They looked at 15 randomised controlled trials covering 2545 patients.
Analysis showed that acupuncture and topiramate were most effective in reduction of monthly headache and migraine days, with botox following closely behind. Acupuncture though, resulted in the fewest treatment-induced adverse events. Topiramate caused the most adverse events and consequently the highest rate of dropouts.
(Topiramate, acupuncture, and BoNT-A for chronic migraine: a network meta-analysis. Acta Neurologica Scandinavica, 3 January 2021.)