Efficacy and Safety of Levetiracetam in Pediatric Migraine

Miller, G. Steve

doi:10.1111/j.1526-4610.2004.04053.x

Cited by 104 publications

(69 citation statements)

References 32 publications

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“…No side effects were reported in 82.4% but 10.5% discontinued treatment because of side effects including somnolence, dizziness, and irritability. 40 Calcium channel blockers. Calcium channel blockers are thought to exert their effects through selective inhibition of vasoactive substances on cerebrovascular smooth muscle.…”

Section: Description Of Processmentioning

confidence: 99%

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

et al. 2004

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Abstract-Objective:To review evidence on the pharmacologic treatment of the child with migraine headache. Methods: The authors reviewed, abstracted, and classified relevant literature. Recommendations were based on a four-tiered scheme of evidence classification. Treatment options were separated into medications for acute headache and preventive medications. Results: The authors identified and reviewed 166 articles. For acute treatment, five agents were reviewed. Sumatriptan nasal spray and ibuprofen are effective and are well tolerated vs placebo. Acetaminophen is probably effective and is well tolerated vs placebo. Rizatriptan and zolmitriptan were safe and well tolerated but were not superior to placebo. For preventive therapy, 12 agents were evaluated. Flunarizine is probably effective. The data concerning cyproheptadine, amitriptyline, divalproex sodium, topiramate, and levetiracetam were insufficient. Conflicting data were found concerning propranolol and trazodone. Pizotifen, nimodipine, and clonidine did not show efficacy. Conclusions: For children (Ͼage 6 years), ibuprofen is effective and acetaminophen is probably effective and either can be considered for the acute treatment of migraine. For adolescents (Ͼ12 years of age), sumatriptan nasal spray is effective and should be considered for the acute treatment of migraine. For preventive therapy, flunarizine is probably effective and can be considered, but is not available in the United States. There are conflicting or insufficient data to make any other recommendations for the preventive therapy of migraine in children and adolescents. For a clinical problem so prevalent in children and adolescents, there is a disappointing lack of evidence from controlled, randomized, and masked trials.

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Section: Description Of Processmentioning

confidence: 99%

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

et al. 2004

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“…For migraine therapy, few studies S69 are available in the literature regarding the use of levetiracetam for both the prophylaxis and attack of migraine. These studies have yielded encouraging results [40][41][42][43], even in children, with a recent retrospective study [44].…”

Section: Levetiracetammentioning

confidence: 94%

Antiepileptic drugs in migraine prophylaxis

2004

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IntroductionThe decision to begin prophylactic therapy for the treatment of migraine depends on the frequency and the severity of the attacks, and to what extent they alter the quality of life of the patients. According to the Diagnostic and Therapeutic Guidelines for migraine and cluster headache of the Italian Society for the Study of Headaches [1], the presence of at least 2 attacks of migraine per month or lasting 4 or more days per month, which do not completely respond to symptomatic therapy, are indications to begin prophylactic therapy.A state of hyperexcitability of the cerebral cortex is considered the neuropathophysiologic basis of migraine, as in epilepsy, and in fact the two pathologies are often comorbid [2]. In a population study, Ottman and Lipton [3] demonstrated that epilepsy and migraine are closely linked pathologic conditions, independent of seizure aetiology, age at first onset and type of crisis. These features, which are shared by these pathologies characterised by attacks, suggest a common pathogenesis involving membrane excitability upon which the antiepileptic drugs can act.From this point of view, the studies of efficacy and tolerability confirm and delineate antiepileptics as very promising drugs in the panorama of the prevention of migraine and other head pain.Antiepileptic and antimigraine drugs act on the nociceptive mechanisms mediated by GABA or glutamate neurotransmission, or both [4]. GABA is the major inhibitory neurotransmitter in the central nervous system and its presynaptic release occurs by a calcium-dependent mechanism [5]. Valproate and gabapentin interfere with GABA metabolism, inhibiting its degradation and transformation into succinate [6], and topiramate potentiates GABA-mediated inhibition by facilitating receptor action [7]. GABA binding to its receptors causes cellular hyperpolarisation and inhibition of postsynaptic transmission. All these drugs modulate the activity of calcium, sodium and potassium ion channels by hyperpolarising and stabilising the membrane [4]. Abstract Research in the field of headache treatment has experienced a marked impetus in the last few years. In the era of the triptans, the treatment modality of this disease has been revolutionised, and though most of the studies conducted have investigated the symptomatic treatment of migraine, less attention has been dedicated to migraine prophylaxis. This review considers the current data available in the literature regarding the use of antiepileptic drugs in migraine prophylaxis, noting the clinical studies that have yielded statistically significant data.

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“…В отдельных исследованиях авторы указывают на возможную эффективность тразодона, леветирацета-ма, габапентина в профилактической терапии мигрени у детей подросткового возраста [22][23][24].…”

Section: профилактическая терапия мигрениunclassified

Migraine and Tension-Type Headache in Children: The Approach to Effective Treatment. Part 2

Sergeev¹

2012

Vopr. sovr. pediatr.

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Доказательная база по эффективности и безопас-ности фармакотерапии головных болей (ГБ) у детей огра-ничена. Детским неврологам приходится использовать неодобренные для применения в педиатрической прак-тике лекарственные средства, индивидуально взвеши-вая возможную пользу и риск развития нежелательных лекарственных реакций. Отсутствие в России четких рекомендаций по симптоматической и профилактиче-ской терапии первичных ГБ в детском возрасте зача-стую приводит к назначению неэффективной (Но-шпа, ноотропы, «сосудистые» препараты, гомеопатические средства) и небезопасной (купирование эпизодов ГБ комбинированными анальгетиками, содержащими метамизол натрия, кодеин или фенобарбитал) терапии. Нередкое следствие таких назначений -ухудшение течения мигрени и головной боли напряжения (ГБН) с формированием хронической ежедневной головной боли, лекарственно-индуцированной головной боли и развитием серьезных нежелательных лекарственных реакций (НЛР).Фармакотерапию мигрени и ГБН подразделяют на симптоматическую (эпизодический прием препарата с целью купирования приступа боли) и профилактическую (регулярная, длительная терапия, направленная на сни-жение частоты и интенсивности болевых приступов). ФАРМАКОТЕРАПИЯ МИГРЕНИСимптоматическая терапия мигрени Целью симптоматической терапии служит быстрое и эффективное купирование приступа ГБ с полной нор-мализацией повседневной активности ребенка и отсут-ствием рецидива болевого синдрома.Основными принципами симптоматического лече-ния приступа мигрени у детей являются следующие:

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Efficacy and Safety of Levetiracetam in Pediatric Migraine

Abstract: In this small retrospective review, levetiracetam was found to be generally well tolerated and appears to be a promising candidate for additional evaluation in well-controlled clinical trials of pediatric patients with migraine.

Cited by 104 publications

References 32 publications

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

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

Antiepileptic drugs in migraine prophylaxis

Migraine and Tension-Type Headache in Children: The Approach to Effective Treatment. Part 2

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