Preventive drugs in childhood and adolescent migraine.
While headaches in children are quite common, the study and characterization of headache disorders in the pediatric age group has historically been limited. In the absence of controlled studies on prophylactic treatment of the primary headache disorders in this age group, the diagnosis of childhood migraine rests on criteria similar to those in adults. Data from adult studies are often extrapolated and applied to children as well. Although it appears that many preventive agents are safe in children, none are currently FDA-approved for this age group. As a result, despite experiencing significant disability, the vast majority of children who present to their physician with migraine headache do not receive prophylactic therapy. Furthermore, controlled clinical trials investigating the use of both abortive and preventive medications in children have suffered from high placebo response rates. The shorter duration of headaches and other characteristic features seen in children are such that designing randomized controlled trials in this age group is more problematic and limiting. As such, treatment practices vary widely, even among specialists, due to the absence of evidence-based guidelines from clinical trials.
Division of Neurology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave - MLC 2015, Cincinnati, OH, 45229-3039, USA, Joanne.Kacperski@cchmc.org.
Joanne
J
Kacperski
Andrew D
AD
Hershey
D000293:Adolescent; D000367:Age Factors; D000927:Anticonvulsants / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002648:Child; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D020773:Headache Disorders / Q000517:prevention & control; D006633:Histamine Antagonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*; D016896:Treatment Outcome
D000927:Anticonvulsants; D000928:Antidepressive Agents; D000959:Antihypertensive Agents; D006633:Histamine Antagonists