Effectiveness of cyproheptadine in the prevention of childhood migraine

Background Migraine is one of the causes of recurrent headache in childhood. Cyproheptadine is well known as an antihistamine, but there are few studies revealing the drug's effect in pediatric migraine. Objective To determine the effectiveness of cyproheptadine in the prophylactic treatment of childhood migraine. Methods A randomized placebo-controlled clinical trial study was performed at Medan. One hundred children with migraine according to the International Headache Society criteria were included in the study. Subjects were divided into two groups, and each group was given either 4 mg cyproheptadine or placebo for 12 weeks. Headache frequency was measured in headache days per month, duration was measured in hours and functional disability was measured by Pediatric Migraine Disability Assessment (PedMID AS). The efficacy was measured before intervention; also 1, 2, and 3 months after intervention. Results A total of 100 patients, with age ranging from 11 to 18 years old (with mean, 15.5 years), were treated with cyproheptadine or placebo for headache. Compared to baseline, there was a significant difference on PedMIDAS grading of migraines in both groups (P 0.05), but there were side effects of cyproheptadine up to 73%. Conclusion Cyproheptadine appears to be effective as an alternative prophylactic treatment of childhood migraine. However, pediatricians should consider the significant side effects of this drug.