Prophylactic Efficacy of Cinnarizine versus Propranolol in the Treatment of Childhood Migraine: A Single-Blind Randomized Clinical Trial

Background Although the development of effective and safe treatments for prophylaxis of migraine headaches represents an important public health concern, only a few medications have been approved by the specific treatment of patients with migraine. We aimed to compare the efficacy of cinnarizine with propranolol in the prophylaxis of pediatric migraine headache. Materials and Methods In a Randomized Clinical Trial, children aged 6-14 years were selected from the patients with migraine admitted to the neurology clinic of Bandar Abbas pediatric Hospital, affiliated to Hormozgan University of Medical Sciences, Bandar Abbas, Iran. Eligible patients (n, 56) were randomly divided into two groups, each comprising 28 patients: the first group administered cinnarizine (37.5 mg/day in children aged 6–12 years and 50 mg/day in children aged 12–17 years), and the second group received propranolol (1-mg/kg/day). The frequency, severity of headaches over the trial period were assessed. Results: After two months of treatment, both groups had significant reduction in headache frequency in comparison with baseline period (p= 0.047), although this difference between groups was not statistically significant. In addition, the mean severe migraine attacks at the end of the second month was significantly lower in the cinnarizine group compared with the propranolol group (p=0.048). At the end of the study 64% (n=18) of patients who had received the cinnarizine and 57% (n=16) of patients who had administered the propranolol, the drugs appeared to have a preventative effect on their headaches. Conclusion: According to the results, Cinnarizine appeared as effective as propranolol for the prophylactic treatment of childhood migraine.

[1]  T. Sprenger,et al.  Current Prophylactic Medications for Migraine and Their Potential Mechanisms of Action , 2018, Neurotherapeutics.

[2]  S. Silberstein,et al.  Histamine and Migraine , 2018, Headache.

[3]  A. Bhandari,et al.  Cinnarizine: A Contemporary Review , 2017, Indian Journal of Otolaryngology and Head & Neck Surgery.

[4]  Tzu-Chou Huang,et al.  Medical Treatment Guidelines for Preventive Treatment of Migraine. , 2017, Acta neurologica Taiwanica.

[5]  M. Siniatchkin,et al.  Migraine in childhood: biobehavioural or psychosomatic disorder? , 2016, The Journal of Headache and Pain.

[6]  R. Teleanu,et al.  Treatment of Pediatric Migraine: a Review. , 2016, Maedica.

[7]  B. Vandermeer,et al.  Drugs for the acute treatment of migraine in children and adolescents. , 2016, The Cochrane database of systematic reviews.

[8]  G. Comi,et al.  Fixed combination of cinnarizine and dimenhydrinate in the prophylactic therapy of vestibular migraine: an observational study , 2015, Neurological Sciences.

[9]  M. Togha,et al.  Efficacy and safety of cinnarizine in the prophylaxis of migraine in children: a double-blind placebo-controlled randomized trial. , 2014, Pediatric neurology.

[10]  M. Togha,et al.  Cinnarizine for the prophylaxis of migraine associated vertigo: a retrospective study , 2014, SpringerPlus.

[11]  N. Razazian,et al.  The effects of cinnarizine versus sodium valproate in migraine prophylaxis , 2013, The International journal of neuroscience.

[12]  M. Togha,et al.  Efficacy and safety of cinnarizine in the prophylaxis of migraine headaches in children: an open, randomized comparative trial with propranolol , 2012, Acta Neurologica Belgica.

[13]  I. Abu-Arafeh,et al.  Prevalence of headache and migraine in children and adolescents: a systematic review of population‐based studies , 2010, Developmental medicine and child neurology.

[14]  M. Togha,et al.  Cinnarizine in refractory migraine prophylaxis: efficacy and tolerability. A comparison with sodium valproate , 2008, The Journal of Headache and Pain.

[15]  P. Tajik,et al.  Open‐Label Trial of Cinnarizine in Migraine Prophylaxis , 2006, Headache.

[16]  K. Linde,et al.  Propranolol for Migraine Prophylaxis , 2004, The Cochrane database of systematic reviews.

[17]  G. Millman,et al.  Migraine headache in children. , 2003, Clinical evidence.

[18]  F. Pierelli,et al.  Cinnarizine in migraine prophylaxis: efficacy, tolerability and predictive factors for therapeutic responsiveness. An open-label pilot trial. , 2003, Functional neurology.

[19]  S. Powers,et al.  PedMIDAS: Development of a questionnaire to assess disability of migraines in children , 2001, Neurology.

[20]  S. Saponara,et al.  Characterization of voltage-gated calcium currents in freshly isolated smooth muscle cells from rat tail main artery. , 2001, Acta physiologica Scandinavica.

[21]  H. Pomerance,et al.  Nelson Textbook of Pediatrics. , 1997, Archives of pediatrics & adolescent medicine.