A migraine is a primary headache disorder characterised by recurrent headaches that are moderate to severe. Typically, the headaches affect one-half of the head, are pulsating in nature, and last from two to 72 hours.Associated symptoms may include nausea, vomiting, and sensitivity to light, sound, or smell.
It’s a common childhood condition. Up to 11 percent of 7- to 11-year-olds and 23 percent of 15-year-olds have migraines.
At 31 sites nationwide, 328 migraine sufferers aged 8 to 17 were randomly assigned to take amitriptyline, topiramate or a placebo pill for 24 weeks. Patients with episodic migraines and chronic migraines were included.
According to a study published Thursday in The New England Journal of Medicine, two of the drugs the antidepressant amitriptyline and the epilepsy drug topiramate used frequently for migraine prevention among children are not as effective as a sugar pill.
The only government-approved migraine medication for kids is topiramate, which is known by the brand names Topamax and Qudexy, but it is only approved for those 12 and up.
The drugs also produced side effects in some children, such as fatigue, dry mouth, and tingling in their hands or feet. A few cases were more severe.
One child on topiramate attempted suicide. Three taking amitriptyline had mood changes; one told his mother he wanted to hurt himself, while another wrote suicide notes at school and was hospitalised.
The results “really challenge what is typical practice today by headache specialists,” said study author Scott Powers, a psychologist at Cincinnati Children’s Hospital’s headache centre.
“The fact that it shows that two of the most commonly used medications are no more effective than a placebo and have adverse effects makes a very clear statement,” said Dr. Leon Epstein, neurology chief at Ann & Robert Lurie H.
Even if the drugs are not effective for children over all, “that doesn’t mean for any one individual, a drug might not work,” said Dr. David Gloss, a neurologist and a methodologist for the American Academy of Neurology.