Effects and Side Effects of Migraine Prophylaxis in Children

2021 ◽  
Author(s):  
Hande Tekin ◽  
Pinar Edem
Keyword(s):  
Side Effects ◽  
Migraine Prophylaxis

scholarly journals P29 The preventative management of migraine headaches in paediatrics

2020 ◽  
Vol 105 (9) ◽  
pp. e21-e21
Author(s):  
Judith Martin
Keyword(s):  
Side Effects ◽  
Controlled Trial ◽  
Treatment Options ◽  
Migraine Prophylaxis ◽  
List Type ◽  
Preventative Treatment ◽  
Clinical Factor ◽  
Childhood Migraine ◽  
Paediatric Patients ◽  
Dosing Regimens

AimTo determine the optimal preventative treatment option for paediatric migraineDesignA retrospective method. A review of 100 paediatric patients who attended outpatient clinics and their clinical outcomes evaluated at day 0, and at their next outpatient appointment (which is approximately 3 months after their first review). Their treatment was analysed to determine if they have remained on their migraine prophylaxis or changed to a different option.SettingChildren outpatient setting in a District General Hospital.Participants100 paediatric patients aged below 18 years of age.InterventionPatients aged below 18 years of age who have a documented diagnosis of migraine. This excluded abdominal migraine.Main Outcome MeasuresTo identify: which classes of drugs are being used for migraine prophylaxis, if there is a drug being used in preference to other drugs, how many preventative treatment options are tried before a preventative treatment is successful, if appropriate dosing regimens are being used for preventative treatment options, the common side effects (if any) of the drugs used in the management of migraine prophylaxis and if a different class of drug is being used for children under 12 years of age and over 12 years of age.Main ResultsPropranolol, topiramate, pizotifen, amitriptyline and gabapentin were medication used as initial treatment for paediatric migraine prophylaxis. Pizotifen was the most commonly used medication (n=71) and had the overall highest positive response rate of 76%. Topiramate, pizotifen and amitriptyline were noted to have caused side effects and prevent the subjects from continuing that course of prophylactic treatment. Age is a clinical factor which can influence the decision to start therapy. With a child’s advancing age, the features of childhood migraine change and therefore different medication may respond to the changing condition. It is evident from this research, pizotifen is used for children under the age of 12 years. However the true reason behind this is unknown. This could be due to the medication licensing or the side effect profile. Further trials are needed to review the demanding consideration on migraine in children of different ages. The BNF-C gives dosing advice on three preventative treatments; pizotifen, topiramate and propranolol. There was overall good compliance with dosing as per the BNFC; 91% in the pizotifen group, 100% in the topiramate group and 82% compliance in the propranolol group. In the BNF-C, for amitriptyline and gabapentin there is no dosing advice for migraine prophylaxis. Therefore, there was no dosing regimens to compare to and achieved 0% compliance with the BNF-C.ConclusionThis research has found pizotifen to be first line treatment for the prevention of migraines. Numerous medication have been identified as potentially preventing migraine but these have either not progressed to fruition or failed to achieve the expected outcomes. Further medication studies are needed to examine their effectiveness for preventing paediatric migraine.ReferencesBarnes N. ( 2019) ‘Migraine Headache in Children’, British Medical Journal. Available at: https://bestpractice.bmj.com/topics/en-gb/678/evidence (Accessed February 2019)Bille BO. ( 1997) ‘A 40-year follow-up of children with migraine’. Cephalalgia 1997;17:488–91. Available at: https://www.ncbi.nlm.nih.gov/pubmed/9209767 (Accessed January 2019)Brandes JL Saper JR, Diamond M, et al. (2004) ‘Topiramate for migraine prevention: A randomized controlled trial’. JAMA. 2004;291:965–973. Available at: https://www.ncbi.nlm.nih.gov/pubmed/14982912 (Accessed January 2019)Forsythe WI, Gillies D, Sills MA. ( 1984) ‘Propranolol in the treatment of childhood migraine’, Developmental Medicine and Child Neurology Journal, 26: 737–41.

If Migraine Prophylaxis Does Not Work, Think About Compliance

Cephalalgia ◽  
1994 ◽  
Vol 14 (6) ◽  
pp. 463-464 ◽  
Author(s):  
TJ Steiner ◽  
T Catarci ◽  
R Hering ◽  
T Whirmarsh ◽  
EGM Couturier
Keyword(s):  
Side Effects ◽  
Real Time ◽  
Pressure Change ◽  
Migraine Prophylaxis ◽  
Event Recorder ◽  
Ihs Criteria ◽  
Lost To Follow Up

Data are presented on nine patients with migraine by IHS criteria, recruited from those presenting to the clinic for treatment and needing prophylaxis. Pizotifen 0.5 mg tds was prescribed for 8 weeks and dispensed in special containers with an electronic event recorder concealed in the lid. This responded to the pressure change with each opening of the container and recorded it in real time. The information was later downloaded to a PC for analysis. At trial end, two patients had been lost to follow-up, one had not started the treatment at all, two had dropped out because of alleged side effects (drowsiness), and four patients had completed the study. For these, the quantity of tablets used as a percentage of that prescribed (i.e., compliance assessed on the basis of returned-tablet count) ranged from 62.6% to 91.9%; the percentage of days in which three doses had been taken ranged from only 15.8% to 79%; the percentage of doses taken on schedule (8 h ± 25% after the previous dose) ranged from 21.1% to 47.3%. It is possible that all evaluations of efficacy and tolerance of migraine prophylactics reported so far have been unsoundly based.

scholarly journals Topiramate-Induced Persistent Eyelid Myokymia

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Mohammadrasoul Khalkhali
Keyword(s):  
Side Effects ◽  
Binge Eating ◽  
Lower Eyelid ◽  
Migraine Prophylaxis ◽  
Upper Eyelid ◽  
Case Presentation ◽  
Eating Problem ◽  
Ocular Side ◽  
Binge Eating Disorders ◽  
Excessive Alcohol

Background. Topiramate (TPM) is a psychotropic drug, which is used mainly as an antiepileptic drug and now over the years is used for a wider range of indications, including migraine prophylaxis and binge eating disorders. Although ocular side effects of Topiramate have been frequently reported, neuroophthalmologic manifestations such as myokymia are rarely reported.Case Presentation. This case report presents a case of a 47-year-old woman who had begun TPM for binge eating problem. She developed unilateral long standing lower eyelid twitching, which progressed to upper eyelid and eyebrow at the same side. The patient was not a smoker or excessive alcohol or caffeine abuser. Increasing the resting time and changing life style made no significant changes in her eyelid twitching. There was no definite evidence by neuroimaging and clinical or laboratory evaluations causing eyelid myokymia. The symptoms resolved with discontinuation of TPM.Conclusion. Although eyelid myokymia is a benign and self-limited condition, it sometimes becomes a source of distress in chronic long standing cases. Physicians should be aware of the neuroophthalmologic side effects of this drug.

Comparison of Propranolol LA 80 mg and Propranolol LA 160 mg in Migraine Prophylaxis: A Placebo Controlled Study

Cephalalgia ◽  
1993 ◽  
Vol 13 (2) ◽  
pp. 128-131 ◽  
Author(s):  
Hisham K Al-Qassab ◽  
Leslie J Findley
Keyword(s):  
Side Effects ◽  
Migraine Prophylaxis ◽  
Controlled Study ◽  
Headache Frequency ◽  
Double Blind ◽  
Once Daily ◽  
Double Blind Placebo ◽  
Headache Severity ◽  
Negative Effect ◽  
Long Acting

Thirty patients with severe classical and common migraine participated in a double-blind placebo-con-trolled cross-over study of migraine prophylaxis with propranolol LA (long-acting) 80 mg once daily, or propranolol LA 160 mg once daily or placebo. Each treatment was given for two months. There were no significant differences between the three treatment periods in headache frequency, headache severity, nausea frequency or severity. There was a non-significant trend for reduced duration of headache with the two doses of propranolol. The possible reasons for this negative effect are discussed. The safety of propranolol and its lack of serious side effects were demonstrated.

scholarly journals What Is the Evidence that Riboflavin Can Be Used for Migraine Prophylaxis?

2016 ◽  
Vol 27 (1) ◽  
pp. 7 ◽  
Author(s):  
Tracey N. Liebman ◽  
Sara C. Crystal
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Mitochondrial Dysfunction ◽  
Symptomatic Treatment ◽  
Oxygen Metabolism ◽  
Migraine Prophylaxis ◽  
Vitamin B2 ◽  
Double Blind ◽  
Prophylactic Agent

Individuals with migraine often have recurrent, painful symptoms, and symptomatic treatments have detrimentalside effects and do not prevent further attacks. Studies indicate that riboflavin can be used to decrease headachefrequency and lessen the need for symptomatic treatment. Mitochondrial dysfunction may play a role in migrainepathogenesis by interfering with oxygen metabolism. Daily doses of riboflavin, vitamin B2, may improve mitochondrialfunction by increasing the reserve of brain mitochondrial energy, and there are minimal side effects with dailytreatment. However, there is a need for further randomized, double-blind controlled studies to determine the effectivedose. Although riboflavin may not fully eliminate migraine nor take effect for several months, riboflavin is apromising prophylactic agent with minimal adverse effects that may significantly reduce the frequency of migraine.

scholarly journals Comparison between flunarizine and levetiracetam in paediatric migraine prophylaxis

2019 ◽  
Vol 51 (1-2) ◽  
pp. 35-39
Author(s):  
Sk Masiur Rahman ◽  
Gopen Kumar Kundu ◽  
Kanij Fatema ◽  
Shaheen Akhter ◽  
Md Mizanur Rahman
Keyword(s):  
Side Effects ◽  
Visual Analogue Scale ◽  
Scale Score ◽  
Visual Analogue Scale Score ◽  
Analogue Scale ◽  
Tertiary Care ◽  
Preventive Therapy ◽  
Migraine Prophylaxis ◽  
Headache Frequency ◽  
Care Hospital

Background: Migraine hampers child's life through school absence, limitation of home and social activities. The goal of prophylactic (preventive) therapy is to reduce headache frequency, headache days, and headache severity with minimum side effects. Objective: To evaluate the efficacy and tolerability of levetiracetam compared to flunarizine as prophylactic treatment of Migraine in children. Methods: This prospective study was carried out in the outpatient department of a tertiary care hospital in Bangladesh. A total of 105 children aged 6-15 years, diagnosed as migraine without aura, were enrolled. Patients were treated with flunarizine or levetiracetam for three months. Headache disabilities were evaluated at baseline and at the end of three months. Results: In flunarizine group, 54 children and in levetiracetam group, 51 children were enrolled. Among them thirty nine children in flunarizine group and 36 children in levetiracetam group completed the study. Headache frequency, headache days, VAS (Visual Analogue Scale) score and PedMIDAS (Paediatric Migraine Disability Assessment Score) score were evaluated at baseline and during the follow up. After three months, headache frequency, headache days, pain severity (Visual Analogue Scale score) reduced significantly compared to baseline (p<0.05). PedMIDAS score was also reduced from 60.35(±16.36) to 30.13(±14.28) in flunarizine group and from 64.25(±19.63) to 25.91(±18.6) in levetiracetam group (p<0.05). Some minor side effects were also reported by both groups, but were well tolerated by the patients and need not withdrawal of medication. Conclusion: Levetiracetam is as effective as flunarizine in paediatric Migraine Prophylaxis. Bang Med J (Khulna) 2018; 51 : 35-39

Flunarizine in Migraine Prophylaxis: Efficacy and Tolerability of 5 mg and 10 mg Dose Levels

Cephalalgia ◽  
1990 ◽  
Vol 10 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Vincenzo Centonze ◽  
Domenica Magrone ◽  
Marcello Vino ◽  
Paola Caporaletti ◽  
Ettore Attolini ◽  
...  
Keyword(s):  
Weight Gain ◽  
Side Effects ◽  
Migraine Prophylaxis ◽  
The Other ◽  
Dose Dependency ◽  
Other Hand ◽  
Dose Levels

The use of flunarizine, a drug which has proven its efficacy in migraine, is often associated with important side effects. The aim of this paper has been to check their incidence at different dose levels (5 mg vs 10 mg). Our data confirm the occurrence of important side effects (in particular weight gain); on the other hand, they emphasize the dose-dependency of the side effects.

Flunarizine-Pizotifen Single-Dose Double-Blind Cross-Over Trial in Migraine Prophylaxis

Cephalalgia ◽  
1986 ◽  
Vol 6 (1) ◽  
pp. 15-18 ◽  
Author(s):  
Rosanna Cerbo ◽  
Massimo Casacchia ◽  
Rita Formisano ◽  
Massimo Feliciani ◽  
Giuliana Cusimano ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Single Dose ◽  
Weight Gain ◽  
Side Effects ◽  
Migraine Prophylaxis ◽  
Calcium Entry Blocker ◽  
Prophylactic Effect ◽  
Double Blind ◽  
Dose Administration ◽  
Definite Difference

The results of a double-blind cross-over clinical trial involving 27 patients with classical or common migraine are described to compare the prophylactic effect of the calcium entry-blocker flunarizine with that of pizotifen. Duration of the treatment was two months, with an evening single-dose administration of both drugs. For most parameters, there was no definite difference between flunarizine and pizotifen in migraine prophylaxis. It has been demonstrated previously that pizotifen is an effective drug in migraine prophylaxis, and these results suggest that flunarizine is effective, too. Weight gain as a side effect was less frequent and less severe with flunarizine than with pizotifen; other side effects showed the same incidence with both drugs.

Supplementation with Riboflavin (Vitamin B2) for Migraine Prophylaxis in Adults and Children: A Review

2015 ◽  
Vol 85 (1-2) ◽  
pp. 79-87 ◽  
Author(s):  
Nazli Namazi ◽  
Javad Heshmati ◽  
Ali Tarighat-Esfanjani
Keyword(s):  
Side Effects ◽  
Key Words ◽  
English Language ◽  
Migraine Prophylaxis ◽  
Vitamin B ◽  
Vitamin B2 ◽  
Insufficient Evidence ◽  
Positive Role ◽  
Migraine Pathogenesis ◽  
Adults And Children

Abstract. Background and Aim: Migraine is a unilateral and pulsating headache associated with nausea, photophobia, vomiting, and sensitivity to light. Low vitamin B2 can lead to mitochondrial dysfunction and may have an effect on migraine pathogenesis. The aim of the present study was to carry out a review of existing evidence regarding the effects of riboflavin (vitamin B2) supplementation on migraine prophylaxis in adults and children. Material and Methods: We searched the databases of PubMed, Science Direct, Google Scholar, and Springer between 1990 and December 2013. Key words included vitamin B2, riboflavin, migraine, vomiting headache, and prevention. We limited our search to human studies in the English language. Review articles and abstracts from symposiums and conferences were excluded. Results: Finally, eleven eligible articles were found: seven involved studies with adults and four involved studies with children. The results indicated that supplementation with vitamin B2 in adults can play a positive role in reducing the frequency and duration of migraine attacks with no serious side effects. Conclusions: It seems that riboflavin is a safe and well-tolerated option for preventing migraine symptoms in adults, however, there is insufficient evidence to make recommendations regarding vitamin B2 as an adjunct therapy in adults and children with migraine.

Gastric Ulcers Produced by Cisplatin

1981 ◽  
Vol 39 ◽  
pp. 582-583
Author(s):  
S.K. Aggarwal ◽  
J. San Antonio
Keyword(s):  
Electron Microscopy ◽  
Single Dose ◽  
Side Effects ◽  
Antitumor Agent ◽  
Gastric Ulcers ◽  
Enzyme Cytochemistry ◽  
Intestinal Toxicity ◽  
Ovarian Cancers ◽  
Inner Surface

Cisplatin (cis-dichlorodiammineplatinum(II)) a potent antitumor agent is now available for the treatment of testicular and ovarian cancers. It is however, not free from its serious side effects including nephrotoxicity, gastro intestinal toxicity, myelosuppression, and ototoxicity. Here we now report that the drug produces peculiar bloating of the stomach in rats and induces acute ulceration.Wistar-derived rats weighing 200-250 g were administered cisplatin(9 mg/kg) ip as a single dose in 0.15 M NaCl. After 3 days the animals were sacrificed by decapitation. The stomachs were removed, the contents analyzed for pepsin and acidity. The inner surface was examined with a dissecting microscope after a moderate stretching for ulcers. Affected areas were fixed and processed for routine electron microscopy and enzyme cytochemistry.The drug treated animals kept on food and water consistently showed bloating and lesions (Fig. 1) with a frequency of 6-70 ulcers in the rumen section of the stomachs.

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