title: Efficacy and safety of cinnarizine in the prophylaxis of migraine in children: a double-blind placebo-controlled randomized trial.
abstract: BACKGROUND
  In spite of the high occurrence of migraine headaches in school-age children, there are currently no approved and widely accepted pharmacologic agents for migraine prophylaxis in children. Our previous open-label study in children revealed the efficacy of cinnarizine, a calcium channel blocker, in migraine prophylaxis. A placebo-controlled trial was conducted to demonstrate the efficacy and safety of cinnarizine in the prophylaxis of migraine in children.
  
  
  METHODS
  A double-blind, placebo-controlled, parallel-group study conducted in a tertiary medical center in Tehran, Iran.
  
  
  METHODS
  Children (5-17 years) who experienced migraines with and without aura, as defined on the basis of 2004 International Headache Society criteria, were recruited into the study. Children were excluded if they had complicated migraine, epilepsy, or a history of use of migraine prophylactic agents. Each participant was randomly assigned to receive cinnarizine (a single 1.5 mg/kg/day dose in children weighing less than 30 kg and a single 50 mg dose in children weighing more than 30 kg, administered at bedtime) or placebo. The frequency, severity, and duration of headaches over the trial period were assessed and adverse effects were monitored.
  
  
  RESULTS
  A total of 68 children (34 in each group) with migraine were enrolled and 62 participants completed the study. After 3 months of taking cinnarizine or placebo, children in both groups experienced significantly reduced frequency, severity, and duration of headaches compared with baseline measurements (P < 0.001). However, compared with 31.3% of children in the placebo group, 60% of children in the cinnarizine group reported more than 50% reduction in monthly headache frequency (P = 0.023), suggesting that cinnarizine was significantly more effective than placebo in reducing the frequency of headaches. No serious adverse effects of the medications were observed in the treated children, including no abnormal weight gain or extrapyramidal signs.
  
  
  CONCLUSIONS
  Our results indicate that the use of cinnarizine at doses administered in this study is effective and safe for prophylaxis of migraine headaches in children.
authors.affiliation: Paediatrics Centre of Excellence, Department of Paediatric Neurology, Children's Medical Centre, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Mahmoud Reza
authors.initials: MR
authors.lastname: Ashrafi
authors.affiliation: Paediatrics Centre of Excellence, Department of Paediatric Neurology, Children's Medical Centre, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Soodeh
authors.initials: S
authors.lastname: Salehi
authors.affiliation: Department of Paediatric Neurology, Golestan Medical, Educational, and Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Reza Azizi
authors.initials: RA
authors.lastname: Malamiri
authors.affiliation: Paediatrics Centre of Excellence, Department of Paediatric Neurology, Children's Medical Centre, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Morteza
authors.initials: M
authors.lastname: Heidari
authors.affiliation: Paediatrics Centre of Excellence, Department of Paediatric Neurology, Children's Medical Centre, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Ahmad
authors.initials: SA
authors.lastname: Hosseini
authors.affiliation: Department of Paediatric Neurology, Golestan Medical, Educational, and Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
authors.forename: Mahboubeh
authors.initials: M
authors.lastname: Samiei
authors.affiliation: Paediatrics Centre of Excellence, Department of Paediatric Neurology, Children's Medical Centre, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ali Reza
authors.initials: AR
authors.lastname: Tavasoli
authors.affiliation: Neurology Department, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran. Electronic address: dr.togha.m@gmail.com.
authors.forename: Mansoureh
authors.initials: M
authors.lastname: Togha
mesh_terms: D000293:Adolescent; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D002936:Cinnarizine / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D002121:Calcium Channel Blockers; D002936:Cinnarizine
keywords: children; cinnarizine; clinical trial; migraine; placebo