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Comparing Pregabalin and Sodium Valproate in Pediatric Migraine Prophylaxis: A Randomized Clinical Trial
Narjes Jafari1, Mohammad Mehdi Nasehi1, Aiden Nasiri Eghbali2
1Pediatrics Neurology Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Pregabalin and Sodium Valproate equally reduced migraine intensity and duration in children. Pregabalin showed a better effect on decreasing migraine frequency and painkiller use, suggesting it as a suitable alternative for prophylaxis.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
Background:
- Migraine is a prevalent neurological disorder in children.
- Prophylaxis with minimal side effects is crucial for pediatric migraine management.
Purpose of the Study:
- To compare the efficacy of Pregabalin and Sodium Valproate in preventing migraine attacks in children.
- To evaluate the impact of these medications on migraine frequency, intensity, duration, and associated anxiety levels.
Main Methods:
- A randomized study involving 64 children (aged 6-18) diagnosed with migraine.
- Participants were assigned to receive either Sodium Valproate or Pregabalin at minimum effective dosages for four months.
- Outcome measures included attack frequency, intensity, duration, painkiller consumption, and anxiety levels using the Spence Children's Anxiety Scale.
Main Results:
- Both Pregabalin and Sodium Valproate demonstrated equal efficacy in reducing migraine intensity and duration.
- Anxiety levels were similarly reduced in both treatment groups.
- Pregabalin showed a statistically significant advantage in decreasing migraine attack frequency and the monthly consumption of painkillers compared to Sodium Valproate by the end of the study.
Conclusions:
- Pregabalin appears to be a potentially effective alternative to Sodium Valproate for prophylactic migraine treatment in children.
- The superior effect of Pregabalin on reducing migraine frequency and painkiller use warrants further consideration in clinical practice.
Objectives:
Migraine is a common disorder in children, and its prophylaxis with minimal side effects is momentous. This study aimed to compare the efficacy of Pregabalin and Sodium Valproate in preventing migraine attacks.
Material & Methods:
Sixty-four children (aged 6-18) with migraines were recruited, as defined by Internation Headache Criteria (ICHD-III). They were randomly assigned to two groups: Sodium Valproate (n=32) and Pregabalin (n=32). The minimum dosage of drugs was prescribed in both groups. The patients were followed for four months. The parameters such as frequency, intensity, duration of migraine attacks, and the number of painkillers that the patients used monthly were recorded. The Spence Children's anxiety scale was also used to evaluate medications' effect on patients' anxiety levels.
Results:
Two medications were equally effective in reducing the intensity and duration of attacks. Additionally, their effect on reducing the anxiety level of patients was equal. There was a significant difference between the effect of drugs on the frequency of migraine attacks at the end of the first and fourth months and the number of painkillers used at the end of the fourth month. The frequency of attacks was decreased by more than 50% in twenty-eight patients (90%) of Pregabalin recipients and twenty-one patients (84%) of Sodium Valproate recipients.
Conclusion:
Considering the better effect of Pregabalin in the reduction of frequency of migraine attacks and pain-reducing medications consumption, Pregabalin could be a proper substitute for Sodium Valproate for prophylactic migraine treatment in children.
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