Levetiracetam Prophylaxis in Pediatric Migraine—An Open‐Label Study

Pakalnis, Ann; Kring, Donna; Meier, Lisa

doi:10.1111/j.1526-4610.2007.00728.x

Cited by 73 publications

(50 citation statements)

References 10 publications

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“…Levetiracetam has been reported to be effective in two open-label studies (Brighina et al, 2006; Pakalnis et al, 2007). The controlled trial reported in chronic daily headache, in which some patients clearly had chronic migraine, was negative (Beran and Spira, 2011).…”

Section: Review Of Literature In Migrainementioning

confidence: 99%

Current Status of the New Antiepileptic Drugs in Chronic Pain

Sidhu

Sadhotra

2016

Front. Pharmacol.

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Antiepileptic drugs (AEDs) are extensively used worldwide to treat a wide range of disorders other than epilepsy, such as neuropathic pain, migraine, and bipolar disorder. Due to this situation more than 20 new third-generation AEDs have been introduced in the market recently. The future design of new AEDs must also have potential to help in the non-epileptic disorders. The wide acceptance of second generation AEDs for the management of various non-epileptic disorders has caused the emergence of generics in the market. The wide use of approved AEDs outside epilepsy is based on both economic and scientific reasons. Bipolar disorders, migraine prophylaxis, fibromyalgia, and neuropathic pain represent the most attractive indication expansion opportunities for anticonvulsant developers, providing blockbuster revenues. Strong growth in non-epilepsy conditions will see Pfizer’s Lyrica become the market leading brand by 2018. In this review, we mainly focus on the current status of new AEDs in the treatment of chronic pain and migraine prophylaxis. AEDs have a strong analgesic potential and this is demonstrated by the wide use of carbamazepine in trigeminal neuralgia and sodium valproate in migraine prophylaxis. At present, data on the new AEDs for non-epileptic conditions are inconclusive. Not all AEDs are effective in the management of neuropathic pain and migraine. Only those AEDs whose mechanisms of action are match with pathophysiology of the disease, have potential to show efficacy in non-epileptic disorder. For this better understanding of the pathophysiology of the disease and mechanisms of action of new AEDs are essential requirement before initiating pre-clinical and clinical trials. Many new AEDs show good results in the animal model and open-label studies but fail to provide strong evidence at randomized, placebo-controlled trials. The final decision regarding the clinical efficacy of the particular AEDs in a specific non-epileptic disorder should be withdrawal from randomized placebo trials rather than open-label studies; otherwise this may lead to off-label uses of drug. The purpose of the present review is to relate the various mechanisms of action of new AEDs to pathophysiological mechanisms and clinical efficacy in neuropathic pain and migraine.

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Section: Review Of Literature In Migrainementioning

confidence: 99%

Current Status of the New Antiepileptic Drugs in Chronic Pain

Sidhu

Sadhotra

2016

Front. Pharmacol.

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“…Two patients (10.5 %) reported no change in headache frequency [28]. In another small open-label study including children ages 6-17 years placed on levetiracetam for migraine prophylaxis (20-40 mg/kg/day), Pakalnis et al [29] found that 18 out of 20 children experienced [50 % reduction in monthly headache frequency (90 % response rate) with a significant decrease in PedMIDAS scores following treatment.…”

Section: Antiepilepticsmentioning

confidence: 95%

Prophylaxis of Migraine in Children and Adolescents

Kacperski

2015

Pediatr Drugs

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While it has been established that headaches in the pediatric age group are relatively common, the characterization of headache disorders and their treatment in this group has historically been limited. Due to the paucity of controlled studies on prophylaxis of the primary headache disorders in children, the diagnosis of migraine often rests on criteria similar to those used in adults. Data from adult studies are often extrapolated and applied to the pediatric patient. Although it appears that many prophylactic agents are safe, well tolerated and efficacious in children, currently only topiramate is FDA-approved for use in patients 12 years and over. As a result, despite often experiencing significant disability, many children who present to their physician with migraines do not receive preventive therapy. One-third of adolescents meet the criteria for warranting prophylactic therapy, yet few are offered a preventative medication. Moreover, controlled clinical trials investigating the use of both abortive and prophylactic medications in children have suffered from high placebo response rates. A diverse group of medications are used to prevent migraine attacks, including antidepressants, antiepileptics, antihistamines and antihypertensive agents, yet there still remains a serious lack of controlled studies on the pharmacological treatment of pediatric migraine.

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“…A practice parameter recently reviewed the available evidence for both acute and preventive therapies in detail as related to pediatric populations [29][30][31][32]. Recent additions to this area have included acute treatments with several triptans; preventive treatment with topiramate [33] and levetiracetam [34]; and the supplement use of coenzyme Q10 [35] and butterbur root extract [36].…”

Section: Treatmentmentioning

confidence: 99%

Pediatric headache

Winner

2008

Current Opinion in Neurology

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A comprehensive management approach blending the most current acute, preventive, and biobehavioral treatments will be reviewed. Further research, with novel study designs, in pediatric headaches is needed to help reveal additional pathophysiological mechanisms, improve diagnostic criteria, and advance optimal treatment. Prospective studies are needed to fully evaluate the efficacy of preventive management in this population and to establish whether early intervention might slow this disease progression.

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Levetiracetam Prophylaxis in Pediatric Migraine—An Open‐Label Study

Abstract: Levetiracetam had some efficacy in reducing migraine frequency and disability. Further larger studies are warranted, possibly utilizing a placebo-controlled design.

Cited by 73 publications

References 10 publications

Current Status of the New Antiepileptic Drugs in Chronic Pain

Current Status of the New Antiepileptic Drugs in Chronic Pain

Prophylaxis of Migraine in Children and Adolescents

Pediatric headache

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