Patterns of Use and Benefit of Triptans in the Treatment of Acute Headache Worsening in Youth With Post-Traumatic Headache.

BACKGROUND

Triptans are used to treat migraine attacks, but little to no evidence supports their use for youth with post-traumatic headache (PTH). This study evaluated patterns of use and benefit of triptans in the treatment of acute headache worsening in youth with PTH.

METHODS

A single-center retrospective cohort study was conducted by reviewing charts for 332 patients aged eight to 17 years seen in a child neurology clinic for PTH within one year of concussion. Treatment responses and side effects were recorded. Demographic and headache characteristics associated with triptan use and treatment response were examined.

RESULTS

Eighty of 332 patients (24.1%) used a triptan. Of those, 34 (42.5%) had acute (less than three months) PTH and 46 (57.5%) had persistent (greater than or equal to three months) PTH. Median time from injury to triptan prescription was 123 days (interquartile range, 50, 242). Older patients, those with headache phenotype consistent with migraine, those who previously used a greater number of treatments for acute headache worsening, and those seen by the headache program were more likely to use triptans (χ > 7.00, P < 0.01). Sixty percent reported at least partial headache relief with their first triptan, whereas 25% reported side effects, all of which were minor.

CONCLUSIONS

These findings show triptans are more likely to be used for youth with PTH with phenotype consistent with migraine that are unrelieved by other treatments for acute headache worsening. Triptans may be an effective treatment for acute headache worsening in youth with PTH, although randomized controlled trials are needed.