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Preventive therapy in pediatric migraine.

W W Wasiewski¹

¹Mayday Pediatric Headache Center, Lancaster, PA 17601, USA. wwwasiew@lha.org

Journal of Child Neurology

|April 9, 2001

Summary

Preventive therapy for pediatric migraine is limited, but amitriptyline and divalproex sodium show potential efficacy in open-label studies. Further research is needed to establish optimal treatment strategies for children experiencing frequent headaches.

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Area of Science:

Neurology
Pediatric Medicine
Pharmacology

Background:

Migraine headache prevention involves identifying triggers, lifestyle changes, acute headache management, and pharmacologic agents.
Limited well-controlled clinical trials exist for pediatric migraine prophylaxis.

Purpose of the Study:

To review the current literature on migraine prophylaxis in children.
To present dosing guidelines based on available data and clinical experience.

Main Methods:

Review of pertinent literature on migraine prophylaxis in children.
Analysis of open-label studies on amitriptyline and divalproex sodium.

Main Results:

No well-controlled trials support agents for pediatric migraine prevention.
Open-label studies suggest potential efficacy for amitriptyline and divalproex sodium.
Mechanisms may involve 5-hydroxytyptamine-2 (5-HT2) receptor antagonism or ion channel regulation.

Conclusions:

Pharmacologic options for pediatric migraine prophylaxis are limited.
Amitriptyline and divalproex sodium show promise but require further investigation.
Dosing guidelines are provided based on limited evidence and clinical expertise.

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