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Prophylactic Migraine Treatment Has No Effect in Children

Findings based on review of 23 studies with variety of treatments compared with placebo

mother and sick son

TUESDAY, Feb. 11, 2020 (HealthDay News) -- There is little evidence supporting the efficacy of prophylactic pharmacologic treatments for pediatric migraine, according to a review published online Feb. 10 in JAMA Pediatrics.

Cosima Locher, Ph.D., from the University of Plymouth in England, and colleagues conducted a systematic literature review to identify clinical trials of prophylactic pharmacologic treatments in children and adolescents diagnosed as having episodic migraine.

Based on 23 identified studies (2,217 patients), the researchers found that prophylactic pharmacologic treatments included antiepileptics, antidepressants, calcium channel blockers, antihypertensive agents, and food supplements. During the short term (less than five months), propranolol (standard mean difference, 0.60; 95 percent confidence interval [CI], 0.03 to 1.17) and topiramate (standard mean difference, 0.59; 95 percent CI, 0.03 to 1.15) were more effective than placebo. There were no significant long-term effects for migraine prophylaxis compared with placebo for any intervention.

"Considering the limited effect size, a cautious, individual, and tailored treatment approach to migraine prophylaxis is of great importance," the authors write.

One author disclosed financial ties to the pharmaceutical industry.

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