THURSDAY, June 23, 2005 (HealthDay News) -- A prescription nasal spray approved for adults with migraines also helps teens, offering potential relief for this underserved population, a Florida researcher reports.
Teens who took zolmitriptan nasal spray (Zomig) for their headache pain were nearly three times more likely to find relief from pain within an hour compared to those given a placebo, said study author Paul Winner, a neurologist and director of the Palm Beach Headache Center.
This is important preliminary research, Winner said, because while there are seven FDA-approved drugs to treat migraines in adults, there are none for teens, who currently rely on often ineffective over-the-counter medications for pain relief.
"There is a lack of awareness that kids have headaches at all, let alone migraines -- this is a dramatically under-diagnosed and under-treated population," Winner said, "and we need to more research to find appropriate FDA-approved, specific treatment for migraines for this population."
Winner was to present the findings Thursday at the American Headache Society's annual meeting in Philadelphia. The study was funded by a grant from AstraZeneca, the maker of Zomig.
The neurologist said that perhaps because most teen migraines are shorter in duration than those of adults -- four to six hours compared to headaches that last several days -- there has been a tendency to dismiss the severity of headaches in those between the ages of 12 and 17.
Another reason for neglect of this group, he said, is that their headaches don't mean they're missing work but rather a half day of school or after-school activities -- "it's a product of what their responsibilities are."
Yet more than one in 10 U.S. teens, an estimated 8 million to 12 million adolescents, get migraines, most during the day, and the headaches can severely impair their lives, Winner said.
The double-blind study included 171 adolescents with migraines who had received no relief from placebo nasal spray. Half then received zolmitriptan nasal spray and half more of the placebo nasal spray.
After an hour, 28 percent of those who had taken the prescription medicine while suffering an attack were pain-free compared to only 10 percent of the placebo group. Further, 51 percent of the children who took zolmitriptan were able to resume their normal activities, while 38 percent of the placebo group were comfortable doing so. Two hours after taking the spray, the 39 percent of the zolmitriptan were pain-free compared to 19 percent of the placebo group.
The adolescents who received the zolmitriptan experienced no serious side effects, Winner added.
Based on the results of this study, Winner said he would be comfortable prescribing the adult medication to teens under certain conditions, including occasional use for those who report a headache once a week --"We do not want it used every day."
However, most doctors and patients are reluctant to use FDA-approved medications for conditions that have not been indicated by the agency's review process, called "off-label" prescribing, so Winner hopes his research will spur others to continue testing triptans for use in adolescents.
"This study is not the first of its kind," said Alan Carver, an assistant professor of neurology at Mount Sinai School of Medicine in New York City, adding that the American Academy of Neurology has issued guidelines on the use of triptans for teens.
Those guidelines, issued in December 2004, included reports of small studies showing that sumatriptan nasal spray (Imitrex) was effective in reducing pain in adolescents and recommended its use for acute migraines in teens.
Carver added, however, that the new research is extremely welcome to doctors who are treating children with migraines.
"What we want is to practice evidence-based medicine to provide some evidence for our conviction that teens with migraines can be given triptans when they are really suffering, just as we treat adults," he said.
More information
Go to The American Academy of Neurology to read guidelines for migraine medicine use among teens.
