Treatment of Juvenile Migraine with Subcutaneous Sumatriptan

Abstract

An open, prospective study was undertaken to assess the efficacy and safety of subcutaneous sumatriptan in 17 children, ages 6 to 16 years, with severe, recurrent migraine. A 6-mg dose was used in 15 patients and relieved headache within 1 hour in six and by 2 hours in five others. Two smaller children received a 3-mg dose and both were headache-free within 2 hours. Most also reported marked improvement in associated symptoms such as nausea and photophobia. Four subjects had no clinical improvement after a 6-mg dose. Side effects, such as neck pressure, were brief and mild. These findings suggest that subcutaneous sumatriptan can be both effective and safe as an abortive agent in juvenile migraine, but the appropriate dose in smaller children will need further investigation.

Practice Parameter: Pharmacological treatment of migraine headache in children and adolescents [RETIRED]

“…The first trial in children 6 to 16 years (n ϭ 17) used the 6 mg dose in children weighing Ͼ30 kg and 3 mg in children Ͻ30 kg. 23 The injection was effective in 64% with side effects including chest pressure, neck pressure, or tingling, lasting 15 minutes, occurring in 15/17 patients.…”

Guidelines for controlled trials of drugs in migraine: Third edition. A guide for investigators

“…(197)(198)(199)(200)(201)(202)(203)(204)(205)(206)(207), and even fewer have shown efficacy. The reasons for lack of effect in children and adolescents of drugs such as oral sumatriptan, which are clearly effective in adults, are uncertain.…”

Pharmacological and behavioral treatment of pediatric migraine and tension-type headache

“…In a report by McDonald [11], subcutaneous sumatriptan at a dosage of 6 mg was effective and well-tolerated in a group of 17 pediatric patients. The 2 smaller children responded to a dosage of 3 mg with only brief neck pressure reported.…”