March 8, 2018
The Question: Does the use of amitriptyline or topiramate work better than a placebo for preventing migraines in children?
The Study: The study included 361 children aged eight to seventeen years old with a history of migraines. The children were randomly assigned to one of the two drugs or a placebo. The baseline was the incidence of headaches in the 28 days before the 24-week study and the headache incidence during the last 29 days of the study. A “success” was if the number of headaches decreased by 50% or more. Other outcomes evaluated were headache-related disability, number of headache days, and serious side effects.
The Results: There were no significant differences in the effectiveness of any of the three regimens. The incidence of significant side effects was higher in the children taking a real medicine compared to the placebo. These side effects included fatigue, dry mouth, numbness, and weight loss.
Comment: The two drugs are commonly used to prevent migraines in adults. This study shows that they are ineffective in children.
Read More: The New England Journal of Medicine, 01/12/17