Recommendations for the management of migraine in paediatric patients

Umberto Balottin, Cristiano Termine

Research output: Contribution to journalArticle

Abstract

Migraine is a common and disabling condition in children and adolescents. The complexity of migraine on a pathogenetic and clinical level results from the interaction between biological, psychological and environmental factors. Appropriate management requires an individually tailored strategy giving due consideration to both pharmacological and non-pharmacological measures. Ibuprofen (7.5 - 10.0 mg/kg) and acetaminophen (15 mg/kg) are safe and effective, and should be considered for symptomatic treatment. Sumatriptan nasal spray (5 and 20 mg) is also likely to be effective, but at the moment, should be considered for the treatment of adolescents only. With reference to prophylactic drug treatment, the available data suggest that flunarizine (5 mg/day) is likely to be effective and pizotifen and clonidine are likely to be ineffective. The efficacy data regarding propranolol, nimodipine and trazodone are conflicting. Insufficient evidence is available on cyproheptadine, amitriptyline, divalproex sodium, topiramate, levetiracetam, gabapentin or zonisamide. The management of migraine in children needs an individualised therapeutic approach, directed to the whole person of the child, taking into account the developmental perspective and the high rate of psychiatric comorbidities. It is the authors' opinion that for the prophylaxis of migraine, interventions such as identification and avoidance of trigger factors, regulation of lifestyle, relaxation, biofeedback, cognitive behavioural treatment and psychological or psychotherapeutic interventions (e.g., psychodynamics) could be much more effective than pharmacotherapy.

Original languageEnglish
Pages (from-to)731-744
Number of pages14
JournalExpert Opinion on Pharmacotherapy
Volume8
Issue number6
DOIs
Publication statusPublished - Apr 2007

Fingerprint

Migraine Disorders
Pediatrics
zonisamide
etiracetam
Pizotyline
Trazodone
Flunarizine
Psychology
Cyproheptadine
Sumatriptan
Nasal Sprays
Therapeutics
Nimodipine
Amitriptyline
Ibuprofen
Valproic Acid
Clonidine
Acetaminophen
Propranolol
Psychiatry

Keywords

  • Acetaminophen
  • Ibuprofen
  • Migraine
  • NSAID
  • Sumatriptan
  • Triptan

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Recommendations for the management of migraine in paediatric patients. / Balottin, Umberto; Termine, Cristiano.

In: Expert Opinion on Pharmacotherapy, Vol. 8, No. 6, 04.2007, p. 731-744.

Research output: Contribution to journalArticle

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