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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
PubMed
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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