Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria.
Paediatr Drugs. 2013 Jun;15(3):235-46. doi: 10.1007/s40272-013-0019-3.
Migraine is a common disease in children and adolescents. The incidence of migraine has increased alarmingly in the general population during recent decades. Migraine causes considerable individual suffering and impaired quality of life. Therefore, appropriate management is essential. In this article, the treatment of acute migraine in children and adolescents will be reviewed. Only a few randomized controlled studies have been published and high placebo rates are a major problem for proving superiority of active drugs. Generally, acetaminophen (paracetamol) and ibuprofen are accepted as drugs of first choice, even though the evidence is poor for the former and limited for latter. Among 14 studies on triptans in adolescents, 9 showed some superiority over placebo with respect to pain relief and pain freedom, and among 6 studies in children, 5 suggest some superiority over placebo. Sumatriptan nasal spray and zolmitriptan nasal spray have been approved for adolescents in Europe; almotriptan has been approved for adolescents in the USA, as has rizatriptan for patients aged 6-17 years. A recent study demonstrated the efficacy of a fixed combination of sumatriptan and naproxen in adolescents with migraine. In conclusion, evidence for the pharmacological treatment of acute migraine in children is very poor and evidence for adolescents is better but still limited.
偏头痛是儿童和青少年的常见疾病。在最近几十年，普通人群中偏头痛的发病率惊人地增加。偏头痛会给患者带来相当大的痛苦和生活质量的下降。因此，适当的治疗至关重要。本文将对儿童和青少年偏头痛急性发作的治疗进行综述。仅有少数随机对照研究发表，且高安慰剂率是证明有效药物优越性的主要问题。一般来说，对乙酰氨基酚（扑热息痛）和布洛芬被认为是首选药物，尽管前者的证据较差，而后者的证据有限。在 14 项关于曲普坦类药物治疗青少年偏头痛的研究中，有 9 项研究显示在缓解疼痛和无疼痛方面优于安慰剂，而在 6 项儿童偏头痛研究中，有 5 项研究显示优于安慰剂。舒马曲坦鼻喷剂和佐米曲普坦鼻喷剂已在欧洲获得批准用于青少年，阿利曲坦已在美国获得批准用于青少年，利扎曲坦也已获得批准用于 6-17 岁的患者。最近的一项研究表明，在偏头痛的青少年患者中，舒马曲坦和萘普生的固定组合具有疗效。总之，儿童偏头痛急性发作的药物治疗证据非常有限，而青少年偏头痛的药物治疗证据虽稍好，但仍有限。
