Migraines are very intense headaches. They most often affect adults but they can also affect children.
There are medicines that children can take to prevent migraines. These are called preventive medicines. If your child is taking preventive medicine, it’s important that they take it every day and don’t skip any doses. Preventive medicine helps to lower the brain’s sensitivity to pain to prevent headaches and the intensity of the headache. Preventive medicines can lower the number of headaches in children by at least half. They are usually started if a child has more than 5 to 8 headaches each month.
Preventative medicines won’t stop headaches right away. It usually takes about 12 weeks before a child begins to have fewer and less intense headaches. Follow up with your child’s healthcare provider if your child doesn’t notice fewer and less intense headaches by 12 weeks.
Most children won’t need to take preventive medicine for the rest of their lives. In most cases, they will take it for about 12 months then stop once they have few headaches.
The following medicines help to prevent headaches in children:
These medicines have side effects. But side effects don’t happen as often when used to treat migraines because the dose tends to be lower. Tell your child’s healthcare provider if they have other medical problems such as sleep problems, depression, anxiety, or seizures. This may help them choose the best medicine for your child.
Calcium channel blockers (CCBs), like flunarizine, work well to prevent migraines in children. CCBs change how the blood vessels in the head react to a migraine and block chemicals that cause headaches. Side effects include feeling tired (fatigue), sleepy, or depressed.
Antihistamines help relieve or prevent allergy symptoms. Cyproheptadine is an antihistamine medicine that is sometimes used to treat frequent migraines in children under 12. Side effects include feeling sleepy and a higher appetite.
Anticonvulsants are medicines that prevent seizures and treat epilepsy. Anticonvulsants such as topiramate (Topomax) also work well to prevent migraines. Topiramate works best to prevent migraines in children between the ages of 12 and 17.
Side effects of topiramate include:
Research shows that anticonvulsant valproic acid (Epival) also works well to prevent migraines in some teens. Side effects of valproic acid include nausea, feeling tired, hair loss, bruising, and weight gain. To lessen nausea, give your child a small snack with this medicine.
Antidepressants are medicines that treat depression. Some antidepressants like amitriptyline and nortriptyline also block certain chemicals in the brain that can help prevent headaches and migraines. Side effects include:
If your child has nausea, give them a snack with this medicine.
Beta-blockers, like propranolol, are normally used to lower blood pressure. But beta-blockers also block chemicals in the brain that can help prevent headaches or migraines. Side effects include:
Some research shows that beta-blockers may affect the airways so let your healthcare provider know if your child has a history of asthma.
There isn’t enough research yet to know for sure if vitamins, herbs and minerals are a useful way to prevent headaches. Some research shows that the following vitamins, herbs and minerals (also called neutraceuticals) may help prevent headaches.
Vitamin B2 (riboflavin) may help prevent headaches by getting more oxygen to the brain since it helps the body make new red blood cells. Vitamin B2 can change urine colour and rarely cause nausea and diarrhea.
Butterbur root may prevent headaches by lessening inflammation in the brain. If you give your child butterbur root, we recommend a safe preparation such as Petadolex that doesn’t have pyrrolizidine alkaloids (which can cause liver damage).
Magnesium supplements can help prevent headaches. People with low magnesium often get headaches every day or have a lot of headaches.
Every child is different so it might take time for your healthcare provider to find the best medicine. Sometimes the type or dose of medicine may need to be changed to manage your child's headaches.
Encourage your child to ask questions about headaches and what they can do to help manage them. Your healthcare provider can help you and your child make a headache management plan.
Current as of: August 28, 2018
Author: Paediatric Neurology, Alberta Health Services
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