Which medications in the drug class Anticonvulsants are used in the treatment of Pediatric Headache?

Updated: Jan 02, 2019
  • Author: J Ivan Lopez, MD, FAAN, FAHS; Chief Editor: George I Jallo, MD  more...
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Answer

Anticonvulsants

When given in doses lower than those generally used for preventing seizures, valproic acid and topiramate usually have antimigraine activity; divalproex sodium (which contains valproic acid) and topiramate have been approved by the FDA for migraine prophylaxis.

Divalproex sodium (Depakote)

Divalproex sodium is a stable coordination compound composed of sodium valproate and valproic acid in a 1:1 molar relationship; it has been approved by the FDA for prevention of migraine in children older than 12 years. It is likely that all forms of valproic acid have similar efficacy. Preparations that can be used include 250 mg tablets, 125 mg sprinkle capsules, and 250 mg/5 mL liquid formulations (US preparations). The mechanism of action in migraine is unknown, but it is reported to act through the inhibitory neurotransmitter gamma-aminobutyric acid in the treatment of epilepsy.

Valproic acid (Stavzor)

Valproic acid has been approved by the FDA for the prevention of migraine in children older than 12 years. The mechanism of action in migraine is unknown, but it is reported to act through the inhibitory neurotransmitter gamma-aminobutyric acid in the treatment of epilepsy.

Gabapentin (Neurontin, Gralise)

Gabapentin is used for migraine headache prophylaxis.

Topiramate (Topamax)

Migraine prophylaxis in adults is a labeled indication for topiramate. Although studies of the use of the drug in adolescents and children are under way, in 2014 the FDA approved the use of topiramate for the prevention of headaches in migraine patients aged 12-17 years. Topiramate is sedating and causes cognitive slowing if the dose is advanced rapidly or the starting dose is high.


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