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Sumatriptan as a First-Line Treatment for Headache in the Pediatric Emergency Department

Jessica Hauser Chatterjee1, Emily A Hartford2, Emily Law3

  • 1Division of Child Neurology, Department of Neurology, University of Washington School of Medicine and the Seattle Children's Research Institute, Center for Integrative Brain Research, Seattle, Washington.

Pediatric Neurology
|March 23, 2023
PubMed

Insights

Intranasal sumatriptan shows promise for treating pediatric migraine in the emergency department (ED). This approach may reduce the need for intravenous therapies, shorten patient stays, and lower healthcare costs.

Area of Science:

  • Pediatric Emergency Medicine
  • Neurology
  • Pharmacology

Background:

  • Headache is a frequent reason for pediatric emergency department (ED) visits.
  • Intranasal (IN) sumatriptan is a safe and effective migraine treatment but is underutilized in pediatric EDs.
  • This study evaluates a novel ED migraine pathway prioritizing IN sumatriptan.

Approach:

  • Retrospective chart analysis of 558 patients (ages 6-21) treated between October 2016 and February 2020.
  • Data collected included demographics, pain scores, treatment, discharge prescriptions, length of stay (LOS), ED charges, and return visits.
  • Compared outcomes for patients receiving IN sumatriptan versus other treatments, including intravenous (IV) therapies.

Key Points:

  • Median pain score decreased from 7 to 2 post-treatment.
  • 48% of patients received IN sumatriptan; 36% of these were prescribed oral sumatriptan at discharge.
  • Use of IV access for headache management correlated with longer LOS and higher ED charges.

Conclusions:

  • IN sumatriptan presents a feasible and effective first-line option for pediatric migraine in the ED.
  • This strategy may decrease reliance on IV therapies, reduce LOS, and lower ED costs.
  • Further research is warranted to compare IN sumatriptan's efficacy against other first-line pediatric migraine treatments.
Abstract

Keywords:
Cost of careIntranasal sumatriptanPediatric emergency departmentPediatric headachePediatric migraineStandardized protocol

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