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Drug treatment of migraine in children: state of the art
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- Author(s): Cuvellier, J.-C. ; Joriot, S.1; Auvin, S.1; Vallée, L.1
- Source:
Archives de Pédiatrie. May2004, Vol. 11 Issue 5, p449-455. 7p. - Source:
- Additional Information
- Alternate Title: Traitement de fond de la migraine de l’enfant : état des connaissances du traitement pharmacologique
- Abstract: Migraine, according to the criteria of the International Headache Society, occurs in about 5–10% of children. Preventive therapy includes identification of migraine precipitants, possible adjustments in lifestyle, appropriate management of acute headache, and when necessary the use of pharmacologic agents. It should be started if migraine attacks are severe or frequent. Non-pharmacologic prophylactic treatment is the modality of choice, based on relaxation or biofeedback. Despite its high incidence, only a few controlled trials have investigated the prophylactic treatment of migraine in children. Only flunarizine (5 mg/day) has been shown to be effective in two double-blind, placebo-controlled trials. Some evidence also exists that propranolol (60 mg/day) and pizotifen (0.5–1.5 mg/day) are effective. For all other drugs studied in migraine prophylaxis, the results remain vague (e.g. amitriptyline), or suggest inefficacy (e.g. clonidine, tryptophane). Most of the drugs used in the treatment of migraine in children are well tolerated. The most common adverse effects are drowsiness and bodyweight gain. [Copyright &y& Elsevier]
- Abstract: La migraine, selon les crite`res diagnostiques de l’International Headache Society, concerne 5 a` 10 % des enfants. Le traitement de fond repose sur une optimisation des habitudes de vie, comprenant l’e´viction des facteurs de´clenchants, et les the´rapeutiques pre´ventives non me´dicamenteuses, comme la relaxation ou le re´trocontroˆle (biofeedback). Le traitement pre´ventif me´dicamenteux est propose´ en cas d’e´chec des mesures pre´ce´dentes et doit tenir compte de la se´ve´rite´ et de la fre´quence des acce`s migraineux. Malgre´ cette incidence e´leve´e, peu d’e´tudes controˆle´es ont e´value´ l’efficacite´ du traitement de fond me´dicamenteux de la migraine chez l’enfant. Deux e´tudes controˆle´es contre placebo ont montre´ l’efficacite´ de la flunarizine, a` la posologie de 5 mg par jour ; une e´tude controˆle´e contre placebo a montre´ l’efficacite´ du propranolol a` la posologie de 60 mg par jour et du pizotife`ne a` la posologie de 0,5 a` 1,5 mg par jour. Pour les autres me´dicaments, certains sont d’efficacite´ possible mais non prouve´e par des e´tudes controˆle´es (amitriptyline), d’autres n’ont pas de´montre´ leur efficacite´ (clonidine, tryptophane). La plupart des me´dicaments utilise´s dans le traitement de fond de la migraine sont bien tole´re´s. Les effets secondaires les plus fre´quents sont la prise de poids et la somnolence. [Copyright 2004 Elsevier]
- Abstract: Copyright of Archives de Pédiatrie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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