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Published on: June 2, 2014
Cyproheptadine Treatment in Children and Adolescents with Migraine: A Retrospective Study in Japan
Hideki Shimomura1, Sachi Tokunaga1, Eisuke Terasaki1,2
1Department of Pediatrics, Hyogo Medical University School of Medicine, Nishinomiya 663-8501, Japan.
Insights
Cyproheptadine effectively treats pediatric migraine, with 68.9% of patients showing reduced headache frequency. However, comorbid neurodevelopmental disorders and orthostatic intolerance (OI) may lower treatment efficacy in children.
Area of Science:
- Pediatric Neurology
- Pharmacology
- Clinical Trials
Background:
- Limited evidence exists for prophylactic migraine drugs in children, particularly with treatment-resistant comorbidities.
- Comorbid neurodevelopmental disorders and orthostatic intolerance (OI) can complicate pediatric migraine management.
Purpose of the Study:
- To evaluate the efficacy of cyproheptadine as a prophylactic treatment for pediatric migraine.
- To explore the impact of comorbid neurodevelopmental disorders and OI on cyproheptadine's effectiveness.
Main Methods:
- Retrospective analysis of 155 pediatric migraine patients treated with cyproheptadine.
- Efficacy assessed by at least a 50% reduction in headache frequency; responders defined accordingly.
- Fisher's exact test and multiple logistic regression used to analyze efficacy and adverse event factors.
Main Results:
- Overall efficacy was 68.9% in 148 evaluated patients.
- Lower efficacy observed in patients with comorbid neurodevelopmental disorders and OI.
- Factors influencing efficacy included headache frequency, cyproheptadine dose, and comorbid conditions.
Conclusions:
- Cyproheptadine demonstrates effectiveness in treating pediatric migraine.
- Comorbidities, specifically neurodevelopmental disorders and OI, are associated with reduced treatment efficacy.
Objective:
Evidence on prophylactic drugs for pediatric migraine is limited, especially when comorbid conditions contribute to treatment resistance. This study evaluated the efficacy of cyproheptadine in children with migraine and explored the impact of comorbid neurodevelopmental disorders and orthostatic intolerance (OI).
Methods:
We retrospectively analyzed pediatric migraine patients treated with cyproheptadine. Efficacy was assessed based on the reduction in headache frequency, with responders defined as patients experiencing at least a 50% reduction in headache episodes. Fisher's exact test analyzed the relationship between efficacy and comorbid conditions or treatment sequence. Multiple logistic regression was performed to identify factors associated with adverse events.
Results:
In total, 155 children (71 males, 84 females) aged 3-15 years were included. Comorbid neurodevelopmental disorders and OI were present in 27 (17.4%) and 22 (14.2%) patients, respectively. Efficacy was evaluated in 148 patients, with 68.9% classified as responders. Patients with comorbid conditions showed lower efficacy. Responders required a lower dose of cyproheptadine (p = 0.039). Multiple logistic regression identified headache frequency, cyproheptadine dose, and comorbid OI and neurodevelopmental disorders as factors influencing treatment efficacy.
Conclusions:
Cyproheptadine is effective in treating pediatric migraine, though patients with neurodevelopmental disorders and OI demonstrated reduced efficacy.
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