The new research published this Monday in the Journal of the American Medical Association (JAMA) Pediatrics shows that most migraine drugs would not work to prevent migraines in children.
Migraines are recurring headaches which can cause moderate to severe throbbing or pulsating pain. The headache is often on one side of the head. A person may also experience nausea, vomiting and weakness along with increased sensitivity to stimulus like sound or light.
Migraines is the third most prevalent illness in the world right now, with roughly 1 billion people suffering globally. Nearly 1 in 4 of United States household includes someone with migraines. 10 percent of the children and 28 percent adolescents suffer from migraines.
The study was conducted to measure how effective these preventive medications are in providing long- and short-term benefits to the pediatric patients. The research was carried out in University of Basel and was funded by Swiss National Science Foundation, the Schweizer-Arau-Foundation, the Theophrastus Foundation, Germany, and Sara Page Mayo Endowment for Pediatric Pain Research, Education and Treatment.
The systematic review included data from MEDLINE, Cochrane, Embase and PsycINFO and only included randomized clinical trials (RCTs) of prophylactic pharmacologic treatments for children and adolescents younger than 18 years. The inclusion criteria included diagnosis of episodic migraine, with or without aura. Primary outcomes under study were safety, efficacy and acceptability of pediatric migraine treatment.
12 different treatments were for efficacy including flunarizine, sodium valproate, topiramate, pregabalin, riboflavin, coenzyme Q10, and placebo. The data from more than 2,000 children showed that no medication for migraine had a long-term effect of 5 to 6 months in children. Some short-term significant improvements of less than 5 months were seen with topiramate and propranolol. US Food and Drug Administration (FDA) has approved the use of topiramate for adolescents, and triptan products for children.
Previously, such research has been conducted to see effects of medication in adults but this study is focused on children and “provides up to date rankings for the different medications used to prevent migraine with regard to their efficacy and safety, allowing providers to assess benefit versus risk for each medication and see how they compare to each other”, according to Joe Kossowsky, PhD, MMSc, of Boston Children’s Hospital and Harvard Medical School, and colleagues.
The researchers added that they are moving on to the next step of their research and will assess the effects of genetic predispositions on medication efficacy in preventing migraines which would allow for a more personalized medicine approach in the future.
The migraine treatment usually includes preventive and pain-relieving medications like ibuprofen, aspirin, acetaminophen, triptans, dihydroergotamines, lasmiditan, opioids, and anti-nausea drugs. Preventive medications include propranolol, metoprolol tartrate, antidepressants, antiseizure drugs, Botox injections, and CGRP monoclonal antibodies. The treatment depends on the severity and frequency of the headaches. Other remedies include relaxation techniques, developing sound sleeping and eating routines, drinking plenty of fluids, keeping track of headaches and exercising regularly.
Mr. Kossowsky, the lead researcher, also suggested that as no medication was found to have long-term benefits in children, the focus should be to adopt a healthy lifestyle, maintain good general health and identifying and avoiding triggers of migraine in children.