Children with migraine often come up against barriers, the most important being their parents. Children have a right not to suffer when treatment is available, but frequently, parents are resistant to have their child use prescribed medication. Children further tend to downplay the impact of the pain on their lives and families.

Migraine is common in childhood and adolescence. Before puberty, boys are affected more commonly than girls.

The same medications used in adults, mainly triptans, are appropriate. Maxalt and Axert are FDA approved for children and teens, but all triptans work and are well tolerated. Preventatives can include the supplement butterbur or prescribed medications similar to those used in adults with migraine. Evidence supports use of Depakote, Topamax, beta-blockers. Depakote is reasonable in children and young teens. It comes in sprinkles for those who cannot swallow pills. Topamax is a good choice for obese teens with caution that higher doses may cause cognitive symptoms. Cyproheptadine has been used for years by pediatricians with little supporting evidence.

We are a Children’s Headache Center, recognized by the National Headache Foundation.

Jack Florin, MD

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