Recent Developments in the Treatment of Migraine in Children and Adolescents
Acute Management in the Pediatric Population
Migraine is thought to occur in 5-10% of the pediatric population . The American Academy of Neurology (AAN) most recently published practice parameter guidelines for the treatment of migraine in children and adolescence in 2004 . Acute treatment in the pediatric population, as in adults, should be aimed at addressing all components of the migraine complex including pain and those associated symptoms that may also contribute to the disability often associated with migraine such as nausea and vomiting. Agents often utilized in the acute management of migraine in adults, such as triptans and non-steroidal anti-inflammatory medications (NSAIDs), are also employed in the treatment of the pediatric population. Treatment may be stratified based on frequency and severity of attacks and their associated disability. Other factors that may determine choices of treatment include migraine associated nausea or vomiting.
Recent Updates in the Use of Triptans in the Pediatric Population
Triptans are a frequently utilized class of medication for the acute treatment of migraine. The agents are agonists at 5HT1B & 5HT1D receptors and are often used when headache attacks are disabling or when more mild headaches do not respond to initial treatments such as NSAIDs or acetaminophen. There are currently seven triptans with FDA approval for use in adults while only three are approved for use the pediatric population: sumatriptan, rizatriptan, and almotriptan. Sumatriptan has been the most widely studied medication from the class, and the AAN has recognized that there is sufficient evidence to support the use of intranasal sumatriptan in the acute treatment of episodic migraine in children .
Source: Freitag FG, Schloemer F, Shumate D. Recent Developments in the Treatment of Migraine in Children and Adolescents. Headache Pain Manag. Case Rep. 2016, 1:1