Just how effective are migraine drugs for kids? A new study is raising some interesting questions about whether or not we should be relying on them.
The study, published in the New England Journal of Medicine, tested topiramate and amitriptyline, both common preventatives. 328 children and adolescents were involved in the trial, which randomized, double-blind and placebo-controlled. A 24 week trial of the medications took place, and a 28 day window of results was compared – once before the medication, and once at the end of the 24 weeks.
The goal was to see a reduction of symptoms of at least 50%. So – how did the medications do?
As you can see, 52% of those on amitriptyline had a 50% or more reduction in symptoms. Pretty good. Let’s check out topiramate:
Even better – 54%. But here’s the problem. Being an well-designed trial, some of the patients were given a placebo – they didn’t take any medicine at all. How did these patients do?
That’s right, the ones who thought they might be taking medicine, but weren’t – they did the best of all.
To further complicate matters, some of the patients experienced side effects from the topiramate and amitriptyline – in some cases, quite serious ones.
Now before we completely write off preventative drugs for children and youth, there are some things to consider. First, this trial only tested one formulation and dose each of two drugs. There are a lot more options out there.
Second, it could very well be that some of these children were greatly helped by the medication who would not have been helped as much by the placebo. Remember, many patients saw a significant reduction in symptoms, and in some cases the medication may have helped with that.
But although this should not be a reason to write off preventative medications for children with migraine, it should suggest that you’ll probably want to try other treatments first – especially non-drug options. Diet, exercise, and certain complimentary treatments are excellent options for children. Take for example biofeedback, physiotherapy and certain supplements.
For more information, see the study abstract here: Trial of Amitriptyline, Topiramate, and Placebo for Pediatric Migraine