Pediatric Migraine

Table 6

Drugs used for prevention of migraine attacks.

Class	Drug & dosage	Comments
Beta blockers	Propranolol 3 mg/kg/day	Reduced energy, tiredness, postural symptoms, contraindicated in asthma, depressive side effects, often limits their usefulness in children
Calcium chanel blockers	Flunarizine, PO, 5 mg	Not available in US
	Nimodipine	Not recommended for use in pediatric migraine
Anticonvulsants	Valproate 15–45 mg/kg/day, PO	Drowsiness, weight gain, tremor, hair loss, fetal abnormalities,haemato-logical or liver abnormalities
	Topiramate 2–3 mg/kg/day, PO	Found to be effective in pediatric migraine. Side effects include cognitive changes, weight loss, and sensory symptoms
	Levetiracetam 250–500 mg	Evaluated in pediatric migraine and found to be effective. About 10% children report somnolence, dizziness, and irritability
Antidepressents	Amitriptyline 1 mg/kg/day, PO	Reduces headache frequency and severity; sedation major side effect
	Trazodone 1 mg/kg/day, divided TID, PO	Current literature: no evidence of benifit
	Pizotefen	Current literature: no evidence of benifit