HealthDay News — For children and adolescents with migraine, amitriptyline and topiramate do not reduce headache frequency or headache-related disability more than placebo, according to a study published online October27 in the New England Journal of Medicine. The research was published to coincide with the annual meeting of the Child Neurology Society, held from October 26 to 29 in Vancouver, Canada.

Scott W. Powers, PhD, from the University of Cincinnati College of Medicine, and colleagues conducted a randomized trial in children and adolescents (age 8 to 17 years) with migraine. Patients were randomly allocated to receive amitriptyline, topiramate, and placebo in a 2:2:1 ratio (132, 130, and 66 patients, respectively). 

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The researchers observed no significant differences between the groups in the primary outcome of a relative reduction of 50% or more in the number of headache days in the comparison of the 28-day baseline period with the last 28 days of the 24-week trial. No significant differences were seen between the groups in headache-related disability, headache days, or the percentage of patients completing the 24-week treatment period. Higher rates of several adverse events were seen for patients who received amitriptyline or topiramate versus placebo.

“There were no significant differences in reduction in headache frequency or headache-related disability in childhood and adolescent migraine with amitriptyline, topiramate, or placebo over a period of 24 weeks,” the authors write.

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