Research Activities, October 2013
Beta blocker propranolol may help prevent migraines in children
Comparative Effectiveness Research
Research on preventing migraines in children indicates that there is limited evidence on the benefits and harms of migraine preventive drugs in children, according to a new research review by AHRQ's Effective Health Care Program.
The quality of migraine studies involving children is generally poor, with few trials providing detailed information. However, limited, low-strength evidence suggests that the beta blocker propranolol is more effective than a placebo for preventing migraine in children, with no bothersome negative effects that could lead to treatment discontinuation.
While the evidence confirms previously published conclusions about the efficacy of propranolol, non-drug treatments, such as stress management, also demonstrated better benefit-to-harm ratios than drug treatments in head-to-head randomly controlled trials. Other strategies, such as antiepileptics and internet-based therapies, were also examined for effectiveness in preventing migraines in children.
Migraine frequency is classified as either episodic or chronic according to the number of monthly migraine days, with episodic migraine being less than 15 days, and chronic migraine lasting 15 or more days. Both migraine types significantly affect children's physical, psychological, and social well-being, and can impose serious lifestyle restrictions. Childhood migraine has also been shown to impair learning and school productivity by 50 percent or more.
More research is needed on the comparative effectiveness of multimodal drug and disease management approaches; the long-term benefits, safety, and adherence with preventive treatments; the effects and risks of off-label drug use for migraine prevention; and the role of children's characteristics that could modify benefits and harms with preventive drugs.
These findings and others can be found in the research review, Migraine in Children: Preventive Pharmacologic Treatments, which can be accessed at http://go.usa.gov/DX75.