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Pediatric migraine: pharmacologic agents for prophylaxis.

Lea S Eiland¹, Lauren S Jenkins, Spencer H Durham

¹Auburn University Harrison School of Pharmacy, Huntsville, AL, USA. eilanls@auburn.edu

The Annals of Pharmacotherapy

|June 7, 2007

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This review identifies medications for pediatric migraine prophylaxis, finding topiramate, valproic acid, and amitriptyline have the most supporting data. Further research is needed to confirm efficacy and guide treatment for children with migraines.

Area of Science:

Pediatric Neurology
Pharmacology
Clinical Trials

Background:

Migraine prophylaxis in children lacks extensive research.
No medications are FDA-approved for pediatric migraine prevention.

Purpose of the Study:

To evaluate existing data on medications used for migraine prophylaxis in children.
To identify effective and ineffective agents for pediatric migraine prevention.

Main Methods:

Comprehensive literature search of multiple databases (PubMed, IDIS, IPA, Cochrane Library) from 1950s-2007.
Inclusion of trials specifically on pediatric migraine headaches, including non-prescription medications.
Review of all available clinical trials, retrospective reviews, and abstracts due to limited data.

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Main Results:

Seventeen drugs were reviewed for pediatric migraine prophylaxis.
Topiramate, valproic acid, flunarizine, amitriptyline, and cyproheptadine showed potential efficacy.
Conflicting or insufficient data exists for several agents; nimodipine, clonidine, and supplements lacked efficacy.

Conclusions:

Topiramate, valproic acid, and amitriptyline have the most evidence for pediatric migraine prophylaxis.
Many agents have limited data or lack efficacy in children.
High-quality, prospective clinical trials are essential for evidence-based pediatric migraine treatment.