Pediatric Migraine Prescription Patterns at a Large Academic Hospital

Johnson, Adriana; Bickel, Jonathan; Lebel, Alyssa

doi:10.1016/j.pediatrneurol.2014.06.018

Cited by 16 publications

(13 citation statements)

References 36 publications

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“…It is also one of the first-line drugs in the management of migraines and cyclical vomiting in childhood. In a series of 4,839 patients aged 2-17 years, evaluated over a period of four years, cyproheptadine was one of the five most frequently used drugs in the management of migraines [50].…”

Section: Cholinergic Modulation Of Inflammationmentioning

confidence: 99%

Neuromodulation in the Management of Allergic Chronic Vaginitis

Theodoropoulos¹,

Àlex²,

Michalopoulou³

et al. 2016

Reprod Syst Sex Disord

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Chronic vaginitis (CV) affects 16% of women. While a number of distinct diagnoses account for the underlying causes of CV, allergic inflammation is also present in a significant number of cases and may range from 25 to 54% of CV patients. Allergic inflammation in CV is encountered as a result of: i) direct sensitization of the vaginal mucosa to latex, local products, Candida, bacteria, etc.; ii) inhalant allergy compounding the chronic vaginitis syndrome; iii) immune cell activation secondary to neurogenic inflammation in the context of chronic neuropathic pain. Despite the varying nature of specific neuro-immune interactions, chronic pain/irritation remains a cardinal feature of CV which needs to be addressed as a priority independently of specific gynecological or allergy-modifying interventions. This is necessary not only for reasons of symptom relief but also because long-term neuronal changes due to inflammation and chronic pain have a profound effect on the course of CV by potentiating adverse pro-inflammatory and degenerating processes. The pathophysiology of these processes and their alteration by means of neuromodulators is presented with a view of long-term control of chronic pain and neurogenic inflammation. Special emphasis is placed on gamma-aminobutyric acid-served pathways, the use of tricyclic antidepressants, serotoninreuptake inhibitors and certain antihistamines with anti-serotoninergic properties.

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Section: Cholinergic Modulation Of Inflammationmentioning

confidence: 99%

Neuromodulation in the Management of Allergic Chronic Vaginitis

Theodoropoulos¹,

Àlex²,

Michalopoulou³

et al. 2016

Reprod Syst Sex Disord

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“…One of the most common classes of abortive medication for migraine used in the ED is dopamine antagonists, which is supported by good evidence. 4,24 In our inpatient cohort, dopamine antagonists were also the most commonly administered migraine-specific medications during hospitalization. It is unclear, however, whether the dopamine antagonists identified in this cohort were used primarily as abortive therapy or as adjunctive treatment for nausea, which is a known side effect of DHE, and published DHE protocols often include coadministration of dopamine antagonists.…”

Section: Discussionmentioning

confidence: 99%

Inpatient Pediatric Migraine Treatment: Does Choice of Abortive Therapy Affect Length of Stay?

Sheridan

Meckler

2016

The Journal of Pediatrics

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“…The prescription patterns of migraine treatments have been at the center of several studies to date . In 2007, Diamond et al, who focused on the analysis of such patterns in the United States, found that only 56.2% of patients with migraine had ever received a medical diagnosis and that 98% of these individuals had used acute treatment for their migraine attacks (49% used over‐the‐counter drugs, 20% prescription medications, and 29% both over‐the‐counter drugs and prescription medications).…”

Section: Discussionmentioning

confidence: 99%

“…A third study, published in 2014 by Johnson et al, aimed at the description of such patterns in a pediatric population being treated in an academic hospital in the United States America. It was discovered that the 5 most commonly prescribed migraine drugs were sumatriptan (15.6%), amitriptyline (12.2%), topiramate (7.1%), ondansetron (6.9%), and cyproheptadine (6.6%) . Interestingly, the share of patients receiving migraine treatments was lower in this study than in all the others.…”

Section: Discussionmentioning

confidence: 99%