Objective: To describe the efficacy and tolerability of the different medications used to treat migraine in children and adolescents.
Development: A literature review of the drug studies involving children and adolescents for the treatment of migraine was conducted. The treatment of migraine is divided into abortive and prophylactic. The different classes of drugs are described in respect to its efficacy and side effects. Few placebo-controlled, double-blind studies are available in children as compared to adults for the treatment of migraine headaches. Only ibuprofen and nasal sumatriptan have been studied and shown to be effective in more than one double blind placebo-controlled study for the abortive treatment of migraine in children. Unlike the adult studies, the oral triptans tested in children have not been effective when compared to placebo. Only flunarizine has shown efficacy in more than one placebo controlled trial for the prophylactic treatment.
Conclusion: Most of the medications used to treat migraine in children and adolescents are well tolerated. The treatment response of migraine in children and adolescents may differ from that of adults. There seems to be a high placebo response rate in the pediatric population. Therefore, further prospective placebo-controlled studies are needed.