Amy A. Gelfand, Alexandra C. Ross, Samantha L. Irwin, Kaitlin A. Greene, William F. Qubty , I. Elaine Allen. Melatonin for Acute Treatment of Migraine in Children and Adolescents: A Pilot Randomized Trial. Headache. First published: 02 September 2020 https://doi.org/10.1111/head.13934
To determine what dose of melatonin is most effective for treating migraine acutely in children and adolescents.
Acute migraine medications may not work for all patients and may cause side effects. Melatonin is effective for migraine prevention in adults and has been used acutely for procedural pain in children. Our goal was to determine whether a “high” or “low” dose of melatonin is more effective for treating migraine acutely in youth.
In this pilot, randomized, open‐label, single‐center, dose‐finding trial, children and adolescents aged 4‐17 years with episodic migraine were randomized to “high‐dose” or “low‐dose” dose melatonin (<40 kg: 4 mg vs. 1 mg; ≥40 kg: 8 mg vs. 2 mg). The primary outcome measure was change in mean pain score between time 0 and 2 hours. Secondary outcomes included 2‐hour pain‐relief and pain‐freedom rates.
As an acute treatment for pediatric migraine, both low and high doses of melatonin were associated with pain reduction; however, study drop‐out was high. Higher dose and napping after treatment predicted greater benefit. _________________________________________________________________
From the article:
Pain was also graded on a continuous scale that participants
could “X” at any point along a 10-cm line, representing 0-10 pain, which was
positioned above the Wong-Baker FACES Pain Rating Scale. The Wong-Baker FACES
Pain Rating Scale is a validated visual analog scale for assessing physical pain in individuals ages 3
and up; the 10-cm line placed above it is a modification…
Neither dose tested hit the primary outcome measure of
decreasing mean pain intensity by at least 3 cm at 2 hours, and there was a
high drop-out rate in both groups.
Melatonin treatment was safe and well tolerated in this
study. Many parents and participants preferred using melatonin to treat their
child’s/their migraine compared to other acute treatments tried previously.
Napping was predictive of headache benefit, suggesting that facilitating sleep is
one of the mechanisms by which melatonin might help migraine acutely.
Courtesy of: https://www.mdlinx.com/journal-summary/melatonin-for-acute-treatment-of-migraine-in-children-and-adolescents-a-pilot-randomized-trial/3x1QgzvcrTsy4Gvwj81q14