Effectiveness of cyproheptadine in the prevention of childhood migraine
Keywords:
cyproheptadine, prophylaxis, childhood migraine
Abstract
Background Migraine is one of the causes of recurrent headachein childhood. Cyproheptadine is well known as an antihistamine,
but there are few studies revealing the drug's effect in pediatric
migraine.
Objective To determine the effectiveness of cyproheptadine in the prophylactic treatment of childhood migraine.
Methods A randomized placebo-controlled clinical trial study
was performed at Medan. One hundred children with migraine
according to the International Headache Society criteria were
included in the study. Subjects were divided into two groups, and
each group was given either 4 mg cyproheptadine or placebo for 12 weeks. Headache frequency was measured in headache days per month, duration was measured in hours and functional disability was measured by Pediatric Migraine Disability Assessment (PedMID AS). The efficacy was measured before intervention; also 1, 2, and 3 months after intervention.
Results A total of 100 patients, with age ranging from 11 to 18 years old (with mean, 15.5 years), were treated with cyproheptadine or placebo for headache. Compared to baseline, there was a significant difference on PedMIDAS grading of migraines in both groups (P<0.05). Headache frequency and duration per month were significantly different after treatment with cyproheptadine (P=0.009, 95% CI 0.001 to 0.030 and P= 0.029, 95% CI 0.690 to 27.510, RR=4.36), compared to placebo group (P> 0.05), but there were side effects of cyproheptadine up to 73%.
Conclusion Cyproheptadine appears to be effective as an
alternative prophylactic treatment of childhood migraine.
However, pediatricians should consider the significant side effects
of this drug.
References
1. Hershey AD, Winner PK. Pediatric migraine: recognition
and treatment. JAO. 2005;105:2-8.
2. Goadsby PJ, Lipton RB, Ferrari MD. Migraine - current
understanding and treatment. N Eng! J Med. 2002;346:257-61.
3. Lazuardi S. Nyeri kepala pada anak dan remaja. In:
Soetomenggolo TS, Ismael S, editors. Buku ajar neurologi
anak. 2nd ed. Jakarta: Balai Penerbit IDAI, 2000; p. 78-86.
4. Goadsby PJ. Recent advances in the diagnosis and
management of migraine. BMJ. 2006;332:25-9.
5. Goadsby PJ, Lipton RB, Ferrari MD. Migraine -current
understanding and treatment. N Eng! J Med. 2002;346:257-61.
6. Rothner D, Menkes JH. Headaches and nonepileptic episodic
disorders. In: Menkes JH, editors. Child Neurology. 17th ed.
Philadelphia: Lippincott Williams & Wilkins, 2006; 943-64.
7. Rao BS, Das DG, Taraknath VR, Sarma Y. A double blind
controlled study of propranolol and cyproheptadine in
migraine prophylaxis. Neurol India. 2000;48:224-6.
8. Abu-Arefeh I, Russel G. Prevalence of headache and migraine
in schoolchildren. BMJ. 1994;309:756-9.
9. Bland SE. Pediatric migraine recognition management. J oumal
of the Pharmacy Society of Wisconsin. 2002;2:41-4.
10. Yisudtibhan A. Migraine in Thai children: Prevalence in
junior high school students. J Child Neurol. 2007;22: 117-20.
11. Lewis OW. Preventive therapy for migraine. In: Maria BL,
editors. Current management in child neurology. Hamilton:
BC Decker Inc, 2005; p. 53-7.
12. Lewis DW. Headaches in infants and children. In: Swaiman
KF, Ashwal S, Ferriera DM, editors. Pediatric Neurology
Principles &Practice. 4th ed. Philadelphia: Mosby Inc, 2006;
p. 1183-99.
13. Spry H, McDiarmid T, Mayer J. What medication best
prevents migraine in children? Clinical inquires: from the
family practical inquiries network. Journal of Family Practice.
2003;24:2-4.
14. Donald W, Lewis MD. Pediatric Migraine. Pediatr Rev.
2007 ;28:43-53.
15. Lewis DW, Ashwal S, Dahl G. Practice parameter: Evaluation
of children and adolescents with recurrent headaches. AAN.
2002;59:490-8.
16. Piland LS, Jenkins LS. Pediatric Migraine: Pharmacologic
agents for prophylaxis. Ann Pharmacother. 2007;41:1181-90.
17. Gunner KB, Smith HD, Ferguson LE. Practice guideline
for diagnosis and management of migraine headaches in
children and adolescents: part two. J Pediatr Health Care.
2008;22:52-9.
18. Snow V, Weiss K, Wall EM, Mottur-Pilson C. Pharmacologic
management of acute attacks of migraine and prevention of
migraine headache. Ann Intern Med. 2002;137:840-9.
19. Barnes NP, Jayawant S. Migraine. Arch Dis Child.
2005;90:53-7.
20. Caruso JM, Brown WD, Exil G, Gascon GO. The efficacy of
divalproex sodium in the prophylactic treatment of children
with migraine. Headache. 2000;40:672-6.
21. Hersey AD, Powers SW, Vockell AL, LeCates S, Kabbouche
M. Effectiveness of topiramate in the prevention of childhood
headaches. Headache. 2002;42:810-8.
22. Hershey AD, Powers SW, Vockell B, LeCates S, Kabbouche
MA, Maynard MK. PedMIDAS development of a
questionnaire to assess disability of migraines in children.
Neurology. 2001;57:2034-9.
23. Hershey AD, Powers SW, Vockell A-LB, LeCates SL, Segers
A, Kabbouche MA. Development of a patient-based grading
scale for PedMIDAS. Cephalgia. 2004;24:844-9.
and treatment. JAO. 2005;105:2-8.
2. Goadsby PJ, Lipton RB, Ferrari MD. Migraine - current
understanding and treatment. N Eng! J Med. 2002;346:257-61.
3. Lazuardi S. Nyeri kepala pada anak dan remaja. In:
Soetomenggolo TS, Ismael S, editors. Buku ajar neurologi
anak. 2nd ed. Jakarta: Balai Penerbit IDAI, 2000; p. 78-86.
4. Goadsby PJ. Recent advances in the diagnosis and
management of migraine. BMJ. 2006;332:25-9.
5. Goadsby PJ, Lipton RB, Ferrari MD. Migraine -current
understanding and treatment. N Eng! J Med. 2002;346:257-61.
6. Rothner D, Menkes JH. Headaches and nonepileptic episodic
disorders. In: Menkes JH, editors. Child Neurology. 17th ed.
Philadelphia: Lippincott Williams & Wilkins, 2006; 943-64.
7. Rao BS, Das DG, Taraknath VR, Sarma Y. A double blind
controlled study of propranolol and cyproheptadine in
migraine prophylaxis. Neurol India. 2000;48:224-6.
8. Abu-Arefeh I, Russel G. Prevalence of headache and migraine
in schoolchildren. BMJ. 1994;309:756-9.
9. Bland SE. Pediatric migraine recognition management. J oumal
of the Pharmacy Society of Wisconsin. 2002;2:41-4.
10. Yisudtibhan A. Migraine in Thai children: Prevalence in
junior high school students. J Child Neurol. 2007;22: 117-20.
11. Lewis OW. Preventive therapy for migraine. In: Maria BL,
editors. Current management in child neurology. Hamilton:
BC Decker Inc, 2005; p. 53-7.
12. Lewis DW. Headaches in infants and children. In: Swaiman
KF, Ashwal S, Ferriera DM, editors. Pediatric Neurology
Principles &Practice. 4th ed. Philadelphia: Mosby Inc, 2006;
p. 1183-99.
13. Spry H, McDiarmid T, Mayer J. What medication best
prevents migraine in children? Clinical inquires: from the
family practical inquiries network. Journal of Family Practice.
2003;24:2-4.
14. Donald W, Lewis MD. Pediatric Migraine. Pediatr Rev.
2007 ;28:43-53.
15. Lewis DW, Ashwal S, Dahl G. Practice parameter: Evaluation
of children and adolescents with recurrent headaches. AAN.
2002;59:490-8.
16. Piland LS, Jenkins LS. Pediatric Migraine: Pharmacologic
agents for prophylaxis. Ann Pharmacother. 2007;41:1181-90.
17. Gunner KB, Smith HD, Ferguson LE. Practice guideline
for diagnosis and management of migraine headaches in
children and adolescents: part two. J Pediatr Health Care.
2008;22:52-9.
18. Snow V, Weiss K, Wall EM, Mottur-Pilson C. Pharmacologic
management of acute attacks of migraine and prevention of
migraine headache. Ann Intern Med. 2002;137:840-9.
19. Barnes NP, Jayawant S. Migraine. Arch Dis Child.
2005;90:53-7.
20. Caruso JM, Brown WD, Exil G, Gascon GO. The efficacy of
divalproex sodium in the prophylactic treatment of children
with migraine. Headache. 2000;40:672-6.
21. Hersey AD, Powers SW, Vockell AL, LeCates S, Kabbouche
M. Effectiveness of topiramate in the prevention of childhood
headaches. Headache. 2002;42:810-8.
22. Hershey AD, Powers SW, Vockell B, LeCates S, Kabbouche
MA, Maynard MK. PedMIDAS development of a
questionnaire to assess disability of migraines in children.
Neurology. 2001;57:2034-9.
23. Hershey AD, Powers SW, Vockell A-LB, LeCates SL, Segers
A, Kabbouche MA. Development of a patient-based grading
scale for PedMIDAS. Cephalgia. 2004;24:844-9.
Published
2009-10-31
How to Cite
1.
Zulkarnain Z, Saing J, Dimyati Y, Saing B. Effectiveness of cyproheptadine in the prevention of childhood migraine. PI [Internet]. 31Oct.2009 [cited 13Nov.2024];49(5):286-1. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/585
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Received 2016-09-11
Accepted 2016-09-11
Published 2009-10-31
Accepted 2016-09-11
Published 2009-10-31
