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Pediatric Migraine: Update on Therapy
Donald Lewis, MD; Marc Avener, MD; Yessid Gozzo, MD
Posted: October 2005
Headache & Pain 2005;16(3):133-140
Objective: This article reviews current
therapeutic options for children with migraine headaches.
Summary: The goals of treatment are the same for
children as they are for adult migraineurs. These include
reduced headache frequency, severity, duration, disability,
and reliance on poorly tolerated, ineffective, or unwanted
medications; improved quality of life; decreased use of abortive
medications; and diminished headache-related distress and
psychological symptoms. A balanced approach with nonpharmacologic
measures, biobehavioral strategies, and medications is key.
The most rigorously studied agents for acute treatment of migraine
are ibuprofen, acetaminophen, and sumatriptan nasal spray, all of
which have been shown to be safe and effective in controlled
trials. For preventative therapy in children and adolescents
with frequent, disabling migraines, flunarizine -- which is not
currently available in the United States -- is most effective.
Encouraging data are emerging for several anti-epileptic agents,
such as topiramate, divalproex sodium, and levatiracetam, as well
as the antihistamine cyproheptadine and the antidepressant