Comparison of Pregabalin and Sodium valproate in Pediatric Migraine Prophylaxis: A Randomized Clinical Trial Comparing Pregabalin and Sodium Valproate in Pediatric Migraine Prophylaxis: A Randomized Clinical Trial
Iranian Journal of Child Neurology,
Vol. 17 No. 3 (2023),
17 July 2023
,
Page 119-129
https://doi.org/10.22037/ijcn.v17i2.36175
Abstract
Objectives:
Migraine is a common disorder in children that its prophylaxis with minimal side effects is momentous. This study aimed to compare the efficacy of Pregabalin and Sodium valproate in preventing migraine attacks.
Material & methods:
Sixty-four children (aged 6-18) with migraines were recruited, as
defined by Internation Headache Criteria (ICHD-III). They were
randomly assigned to two groups: Sodium Valproate (n=32) and
Pregabalin (n=32). The minimum dosage of drugs was prescribed
in both groups. The patients were followed for four months. The
parameters such as frequency, intensity, duration of migraine attacks,
and the number of painkillers that the patients used monthly were
recorded. The Spence Children’s anxiety scale was also used to
evaluate medications’ effect on patients’ anxiety levels.
Results
Two medications were equally effective in reducing the intensity and
duration of attacks. Additionally, their effect on reducing the anxiety
level of patients was equal. There was a significant difference between
the effect of drugs on the frequency of migraine attacks at the end of
the first and fourth months and the number of painkillers used at the
end of the fourth month. The frequency of attacks was decreased by
more than 50% in twenty-eight patients (90%) of Pregabalin recipients
and twenty-one patients (84%) of Sodium Valproate recipients.
Conclusion
considering the better effect of Pregabalin in the reduction of frequency of migraine attacks and pain-reducing medications consumption, Pregabalin could be a proper substitute to Sodium valproate for migraine prophylactic treatment in children.
- Pregabalin, Valproic Acid, Migraine Disorders, Pediatrics
How to Cite
References
2. Split W, Neuman W. Epidemiology of migraine among students from randomly selected secondary schools in Lodz. Headache: The Journal of Head and Face Pain. 1999 Jul;39(7):494-501.
3. Lewis D, Ashwal S, Hershey AO, Hirtz D, Yonker M, Silberstein S. Practice parameter: pharmacological treatment of migraine headache in children and adolescents: report of the American Academy of Neurology Quality Standards Subcommittee and the Practice Committee of the Child Neurology Society. Neurology. 2004 Dec 28;63(12):2215-24.
4. Lewis DW, Winner P. The pharmacological treatment options for pediatric migraine: an evidence-based appraisal. NeuroRx. 2006 Apr 1;3(2):181-91.
5. Hershey AD,Winner P,Kabbouche MA,Power SA.Headache.CurrOpin2007:19:663-9.
6. Lewis KS.Pediatric headache.SeminPediatr Neurol.2010;17:224-9.
7. Kacperski J. Prophylaxis of migraine in children and adolescents. Pediatric Drugs. 2015 Jun 1;17(3):217-26.
8. Corbo J. The role of anticonvulsants in preventive migraine therapy. Current Pain and Headache Reports. 2003 Feb 1;7(1):63-6.
9. Capuano A, Vollono C, Mei D, Pierguidi L, Ferraro D, Di GT. Antiepileptic drugs in migraine prophylaxis: state of the art. La Clinicaterapeutica. 2004;155(2-3):79-87.
10. Linde M, Mulleners WM, Chronicle EP, McCrory DC. Valproate (valproic acid or Sodium valproate or a combination of the two) for the prophylaxis of episodic migraine in adults. Cochrane Database of Systematic Reviews. 2013(6).
11. Serdaroglu G, Erhan E, Tekgul H, Oksel F, Erermis S, Uyar M, Tutuncuoglu S. Sodium valproate prophylaxis in childhood migraine. Headache: The Journal of Head and Face Pain. 2002 Sep;42(8):819-22.
12. Caruso JM, Brown WD, Exil G, Gascon GG. The efficacy of divalproex sodium in the prophylactic treatment of children with migraine. Headache: The Journal of Head and Face Pain. 2000 Sep;40(8):672-6.
13. Gajraj NM. Pregabalin: its pharmacology and use in pain management. Anesthesia & Analgesia. 2007 Dec 1;105(6):1805-15.
14. Mckeage K and KeamSJ.Pregabalin:In the treatment of postherpeticneuralgia.Drugs Aging(2009)26:883-92.
15. Linde M, Mulleners WM, Chronicle EP, McCrory DC. Antiepileptics other than gabapentin, Pregabalin, topiramate, and valproate for the prophylaxis of episodic migraine in adults. Cochrane Database of Systematic Reviews. 2013(6).
16. The international classification of headache disorders (beta version). 3rd ed. Cephalagia (2013) 33: 629-808.
17. Essau CA, Muris P, Ederer EM. Reliability and validity of the Spence Children's Anxiety Scale and the Screen for Child Anxiety Related emotional disorders in German children. Journal of behavior therapy and experimental psychiatry. 2002 Mar 1;33(1):1-8.
18. Koechlin H, Kossowsky J, Lam TL, Barthel J, Gaab J, Berde CB, Schwarzer G, Linde K, Meissner K, Locher C. Nonpharmacological Interventions for Pediatric Migraine: A Network Meta-analysis. Pediatrics. 2021 Apr 1;147(4).
19. Papetti L, Ursitti F, Moavero R, Ferilli MA, Sforza G, Tarantino S, Vigevano F, Valeriani M. Prophylactic treatment of pediatric migraine: is there anything new in the last decade?. Frontiers in neurology. 2019 Jul 16;10:771.
20. Lewis DW, Diamond S, Scott D, Jones V. Prophylactic treatment of pediatric migraine. Headache: the journal of head and face pain. 2004 Mar;44(3):230-7.
21. Ashrafi MR, Shabanian R, Zamani GR, Mahfelati F. Sodium valproate versus propranolol in paediatric migraine prophylaxis. European Journal of Paediatric Neurology. 2005 Sep 1;9(5):333-8.
22. Caruso JM, Brown WD, Exil G, Gascon GG. The efficacy of divalproex sodium in the prophylactic treatment of children with migraine. Headache: The Journal of Head and Face Pain. 2000 Sep;40(8):672-6.
23. Kozubski W, Prusiński A. Sodium valproate versus propranolol in the prophylactic treatment of migraine. Neurologiaineurochirurgiapolska. 1995 Nov 1;29(6):937-47.
24. Kaniecki RG. A comparison of divalproex with propranolol and placebo for the prophylaxis of migraine without aura. Archives of neurology. 1997 Sep 1;54(9):1141-5.
25. Freitag FG, Collins SD, Carlson HA, Goldstein J, Saper J, Silberstein S, Mathew N, Winner PK, Deaton R, Sommerville K. A randomized trial of divalproex sodium extended-release tablets in migraine prophylaxis. Neurology. 2002 Jun 11;58(11):1652-9.
26. Hesami O, Shams MR, Ayazkhoo L, Assarzadegan F, Lima BS, Kasmaei HD, Sistanizad M. Comparison of Pregabalin and Sodium valproate in migraine prophylaxis: a randomized double-blinded study. Iranian journal of pharmaceutical research: IJPR. 2018;17(2):783
27. Bakhshandeh Bali A,Rahbarimanesh A A,SadeghiM,SedighiM,KarimzadehP,GhofraniM.Comparison of propranolol and Pregabalin for prophylaxis of childhood migraine.arandomised control trial.Acta Med Iran.2015;53(5):276-80.
28. Bidabadi E, Mashouf M. A randomized trial of propranolol versus Sodium valproate for the prophylaxis of migraine in pediatric patients. Pediatric Drugs. 2010 Aug 1;12(4):269-75.
29. Mitsikostas DD, Polychronidis I. Valproate versus flunarizine in migraine prophylaxis: a randomized, double-open, clinical trial. Functional neurology. 1997 Sep 1;12(5):267-76.
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