- A meta-analysis shows that prophylactic pharmacological treatment for pediatric migraine, including β-blockers, anticonvulsants, antidepressants, and antihistaminic and calcium channel blockers, offers no significant benefit over placebo.
Why this matters
- Migraines are common in children, with the incidence increasing as children age, but most treatment options are based on studies in adults.
- A systematic review and network meta-analysis (NMA) of 23 randomized clinical trials of prophylactic pharmacologic treatments for episodic migraine in children and adolescents aged
- Funding: Sara Page Mayo Endowment for Pediatric Pain Research, Education, and Treatment.
- Antiepileptics, antidepressants, calcium channel blockers, antihypertensive agents, and food supplements were studied.
- When combined in NMA there was a significant effect of:
- Propranolol: 0.60 (95% CI, 0.03-1.17).
- Topiramate: 0.59 (95% CI, 0.03-1.15).
- Nonsignificant 95% prediction intervals were noted with:
- Propranolol vs placebo: −0.62 to 1.82.
- Topiramate vs placebo: −0.62 to 1.80.
- Other interventions showed nonsignificant standardized mean differences:
- Range was −0.21 (95% CI, −1.40 to 0.99) for L-5-hydroxytryptophan to 0.93 (95% CI, −0.12 to 1.98) for flunarizine.
- Most substances were tested in
Coauthored with Chitra Ravi, MPharm