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Headaches in Children

Medicines for migraines in children

Migraines are very bad headaches. They mostly affect adults, but children can get migraines too.

What medicines can my child take for migraines?

Medicines for migraines in children are called preventive medicines. They help make the brain less sensitive to pain, which can stop migraines and make them less painful. Preventive medicines for migraines include:

  • calcium channel blockers
  • antihistamines
  • anticonvulsants
  • antidepressants
  • beta-blockers
  • vitamins and minerals

Your child might start preventive medicines if they have more than 5 and up to 8 migraines a month. Preventive medicine can help lower the number of migraines your child gets by half or more.

If your child is taking preventive medicine, they need to take it every day without skipping a dose. Preventative medicines take about 12 weeks to start working. Talk to your healthcare provider if your child’s medicine isn’t working after 12 weeks.

These medicines are used in low doses to treat migraines, so their side effects tend to be mild.

Your healthcare provider can help you choose the best medicine for your child. Tell them if your child has any other health concerns (such as problems with sleep, depression, anxiety, or seizures).

Most children don’t need preventive medicine for the rest of their lives. They usually take it for about 12 months and stop once they have few migraines.

Calcium channel blockers (CCBs)

CCBs, like flunarizine, work well for migraines in children. CCBs change how blood vessels in the head react to a migraine and block chemicals that cause it. Side effects include feeling tired, sleepy, or depressed.

Antihistamines

Antihistamines help with allergy symptoms. Cyproheptadine is an antihistamine. It’s sometimes used for children under 12 years old who have migraines often. Side effects include feeling sleepy and hungrier than usual.

Anticonvulsants

Anticonvulsants are medicines for seizures and epilepsy. Topiramate (Topomax) is an anticonvulsant that works well to stop migraines. It works best in children between 12 and 17 years old.

Side effects of topiramate include:

  • feeling tired
  • mood changes
  • taste changes
  • kidney stones
  • trouble concentrating
  • feeling numb and tingly
  • sweating less
  • feeling less hungry than usual
  • losing weight

Research shows that the anticonvulsant valproic acid (Epival) also works well on migraines in some teens. Its side effects include nausea (feeling sick to your stomach), feeling tired, losing hair, bruising, and gaining weight. If your child has nausea, give them a snack with this medicine.

Antidepressants

Antidepressants are medicines that treat depression. Some antidepressants like amitriptyline and nortriptyline also block chemicals in the brain to stop migraines. Side effects include:

  • dry mouth
  • feeling sleepy
  • sudden weight gain
  • feeling dizzy when changing positions
  • sweating or flushing of the skin
  • nausea

If your child has nausea, give them a snack with this medicine.

Beta-blockers

Beta-blockers, like propranolol, are normally used to lower blood pressure. But they also block chemicals in the brain that can help stop migraines. Side effects include:

  • nausea
  • vomiting
  • diarrhea (loose stool)
  • not feeling hungry
  • belly pain

Some research shows that beta-blockers may affect the airways. Tell your healthcare provider if your child has a history of asthma.

Vitamins, herbs, and minerals

There isn’t enough research to know if vitamins, herbs, and minerals can help stop migraines. But some research shows the following may help:

  • Vitamin B2 (riboflavin) helps the body make new red blood cells, which may help stop migraines. Vitamin B2 can change the colour of your child’s pee. Rarely, it can cause nausea and diarrhea.
  • Magnesium supplements can help stop migraines. Children with low magnesium often get migraines.

How do I know what migraine medicine will work for my child?

Every child is different. It might take time to find the best medicine for your child. Your child might need to try a different type or dose of medicine to manage their migraines.

Encourage your child to ask questions about migraines. Ask your healthcare provider to help you and your child make a plan to manage migraines.

Current as of: October 25, 2021

Author: Pediatric Neurology, Alberta Health Services