What can be done for children under the age of 6 years who suffer from migraines?
—Sharon R. Bass, MD, Morgan City, La.
Recommendations for migraine therapy in children include lifestyle modifications, such as regular sleep habits, meals, and exercise, as well as avoidance of triggers, including chocolate, caffeine, or stress. For acute treatment, ibuprofen 7.5-10 mg/kg and acetaminophen 15 mg/kg are recommended. Nasal sumatriptan is effective in adolescents. Studies in adults have demonstrated the effectiveness of many drug classes in prophylactic treatment of migraines, but studies in children have provided insufficient evidence for recommendations because of small sample size and high placebo response rates. Agents used include cyproheptadine, propranolol, and topiramate, although studies involving young children are lacking.
—Michael E. Ryan, DO (103-1)