Drugs for preventing migraine headaches in children

Suresh Victor; Steven Ryan

doi:10.1002/14651858.CD002761

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Analysis 1.1

Comparison 1 Flunarizine vs. placebo, Outcome 1 Frequency.

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Analysis 1.2

Comparison 1 Flunarizine vs. placebo, Outcome 2 Duration.

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Analysis 1.3

Comparison 1 Flunarizine vs. placebo, Outcome 3 Duration and frequency (> 50% reduction).

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Analysis 1.4

Comparison 1 Flunarizine vs. placebo, Outcome 4 Adverse events resulting in withdrawal.

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Analysis 2.1

Comparison 2 Nimodipine vs. placebo, Outcome 1 Frequency.

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Analysis 2.2

Comparison 2 Nimodipine vs. placebo, Outcome 2 Duration.

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Analysis 2.3

Comparison 2 Nimodipine vs. placebo, Outcome 3 Adverse events.

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Analysis 3.1

Comparison 3 Propranolol vs. placebo, Outcome 1 Frequency (> 67% reduction).

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Analysis 3.2

Comparison 3 Propranolol vs. placebo, Outcome 2 Frequency.

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Analysis 3.3

Comparison 3 Propranolol vs. placebo, Outcome 3 Adverse events.

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Analysis 4.1

Comparison 4 Timolol vs. placebo, Outcome 1 Adverse events resulting in withdrawal.

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Analysis 5.1

Comparison 5 Papaverine vs. placebo, Outcome 1 Frequency (50% or greater reduction).

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Analysis 5.2

Comparison 5 Papaverine vs. placebo, Outcome 2 Adverse events resulting in withdrawal.

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Analysis 6.1

Comparison 6 Pizotifen vs. placebo, Outcome 1 Adverse events.

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Analysis 7.1

Comparison 7 Trazodone vs. placebo, Outcome 1 Frequency.

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Analysis 7.2

Comparison 7 Trazodone vs. placebo, Outcome 2 Duration.

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Analysis 7.3

Comparison 7 Trazodone vs. placebo, Outcome 3 Adverse events.

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Analysis 8.1

Comparison 8 L‐5‐hydroxytryptophan vs. placebo, Outcome 1 Frequency.

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Analysis 8.2

Comparison 8 L‐5‐hydroxytryptophan vs. placebo, Outcome 2 Migraine index.

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Analysis 8.3

Comparison 8 L‐5‐hydroxytryptophan vs. placebo, Outcome 3 Migraine index (> 70% improvement).

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Analysis 8.4

Comparison 8 L‐5‐hydroxytryptophan vs. placebo, Outcome 4 Adverse events.

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Analysis 9.1

Comparison 9 Clonidine vs. placebo, Outcome 1 Frequency (no attacks).

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Analysis 9.2

Comparison 9 Clonidine vs. placebo, Outcome 2 Duration (< 4 hours).

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Analysis 9.3

Comparison 9 Clonidine vs. placebo, Outcome 3 Intensity (mild).

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Analysis 9.4

Comparison 9 Clonidine vs. placebo, Outcome 4 Adverse events.

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Analysis 10.1

Comparison 10 Metoclopramide vs. placebo, Outcome 1 Therapeutic effectiveness index (>70% improvement).

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Analysis 11.1

Comparison 11 Domperidone vs. placebo, Outcome 1 Therapeutic effectiveness index (> 70% improvement).

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Analysis 12.1

Comparison 12 Flunarizine vs. acetylsalicylic acid, Outcome 1 Frequency (50% or greater reduction).

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Analysis 12.2

Comparison 12 Flunarizine vs. acetylsalicylic acid, Outcome 2 Adverse events.

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Analysis 13.1

Comparison 13 Flunarizine vs. nimodipine, Outcome 1 Frequency (> 50% reduction).

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Analysis 13.2

Comparison 13 Flunarizine vs. nimodipine, Outcome 2 Adverse events.

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Analysis 14.1

Comparison 14 Flunarizine vs. propranolol, Outcome 1 Frequency (> 75% reduction).

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Analysis 14.2

Comparison 14 Flunarizine vs. propranolol, Outcome 2 Adverse events.

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Analysis 15.1

Comparison 15 Flunarizine vs. dihydroergotamine, Outcome 1 Frequency.

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Analysis 15.2

Comparison 15 Flunarizine vs. dihydroergotamine, Outcome 2 Duration.

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Analysis 15.3

Comparison 15 Flunarizine vs. dihydroergotamine, Outcome 3 Intensity.

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Analysis 15.4

Comparison 15 Flunarizine vs. dihydroergotamine, Outcome 4 Adverse events.

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Analysis 16.1

Comparison 16 Metoclopramide vs. domperidone, Outcome 1 Therapeutic effectiveness index (> 70% improvement).

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Analysis 17.1

Comparison 17 L‐5‐hydroxytryptophan vs. pizotifen, Outcome 1 Headache index.

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Analysis 17.2

Comparison 17 L‐5‐hydroxytryptophan vs. pizotifen, Outcome 2 Pain total index.

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Analysis 17.3

Comparison 17 L‐5‐hydroxytryptophan vs. pizotifen, Outcome 3 Adverse events.

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Comparison 1. Flunarizine vs. placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Frequency Show forest plot	1		Std. Mean Difference (IV, Fixed, 95% CI)	Totals not selected

2 Duration Show forest plot	1		Std. Mean Difference (IV, Fixed, 95% CI)	Totals not selected

3 Duration and frequency (> 50% reduction) Show forest plot	1		Odds Ratio (M‐H, Fixed, 95% CI)	Totals not selected

4 Adverse events resulting in withdrawal Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 1. Flunarizine vs. placebo

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Comparison 2. Nimodipine vs. placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Frequency Show forest plot	1		Std. Mean Difference (IV, Fixed, 95% CI)	Totals not selected

2 Duration Show forest plot	1		Std. Mean Difference (IV, Fixed, 95% CI)	Totals not selected

3 Adverse events Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 2. Nimodipine vs. placebo

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Comparison 3. Propranolol vs. placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Frequency (> 67% reduction) Show forest plot	1		Odds Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2 Frequency Show forest plot	1		Std. Mean Difference (IV, Fixed, 95% CI)	Totals not selected

3 Adverse events Show forest plot	2	134	Risk Difference (M‐H, Fixed, 95% CI)	0.03 [‐0.10, 0.16]

Comparison 3. Propranolol vs. placebo

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Comparison 4. Timolol vs. placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Adverse events resulting in withdrawal Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 4. Timolol vs. placebo

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Comparison 5. Papaverine vs. placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Frequency (50% or greater reduction) Show forest plot	1		Odds Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2 Adverse events resulting in withdrawal Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 5. Papaverine vs. placebo

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Comparison 6. Pizotifen vs. placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Adverse events Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 6. Pizotifen vs. placebo

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Comparison 7. Trazodone vs. placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Frequency Show forest plot	1		Std. Mean Difference (IV, Fixed, 95% CI)	Totals not selected

2 Duration Show forest plot	1		Std. Mean Difference (IV, Fixed, 95% CI)	Totals not selected

3 Adverse events Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 7. Trazodone vs. placebo

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Comparison 8. L‐5‐hydroxytryptophan vs. placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Frequency Show forest plot	1		Std. Mean Difference (IV, Fixed, 95% CI)	Totals not selected

2 Migraine index Show forest plot	1		Std. Mean Difference (IV, Fixed, 95% CI)	Totals not selected

3 Migraine index (> 70% improvement) Show forest plot	1		Odds Ratio (M‐H, Fixed, 95% CI)	Totals not selected

4 Adverse events Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 8. L‐5‐hydroxytryptophan vs. placebo

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Comparison 9. Clonidine vs. placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Frequency (no attacks) Show forest plot	1		Odds Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2 Duration (< 4 hours) Show forest plot	1		Odds Ratio (M‐H, Fixed, 95% CI)	Totals not selected

3 Intensity (mild) Show forest plot	1		Odds Ratio (M‐H, Fixed, 95% CI)	Totals not selected

4 Adverse events Show forest plot	2	143	Risk Difference (M‐H, Fixed, 95% CI)	0.05 [‐0.06, 0.15]

Comparison 9. Clonidine vs. placebo

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Comparison 10. Metoclopramide vs. placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Therapeutic effectiveness index (>70% improvement) Show forest plot	1		Odds Ratio (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 10. Metoclopramide vs. placebo

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Comparison 11. Domperidone vs. placebo

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Therapeutic effectiveness index (> 70% improvement) Show forest plot	1		Odds Ratio (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 11. Domperidone vs. placebo

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Comparison 12. Flunarizine vs. acetylsalicylic acid

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Frequency (50% or greater reduction) Show forest plot	1		Odds Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2 Adverse events Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 12. Flunarizine vs. acetylsalicylic acid

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Comparison 13. Flunarizine vs. nimodipine

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Frequency (> 50% reduction) Show forest plot	1		Odds Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2 Adverse events Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 13. Flunarizine vs. nimodipine

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Comparison 14. Flunarizine vs. propranolol

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Frequency (> 75% reduction) Show forest plot	1		Odds Ratio (M‐H, Fixed, 95% CI)	Totals not selected

2 Adverse events Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 14. Flunarizine vs. propranolol

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Comparison 15. Flunarizine vs. dihydroergotamine

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Frequency Show forest plot	1		Std. Mean Difference (IV, Fixed, 95% CI)	Totals not selected

2 Duration Show forest plot	1		Std. Mean Difference (IV, Fixed, 95% CI)	Totals not selected

3 Intensity Show forest plot	1		Std. Mean Difference (IV, Fixed, 95% CI)	Totals not selected

4 Adverse events Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 15. Flunarizine vs. dihydroergotamine

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Comparison 16. Metoclopramide vs. domperidone

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Therapeutic effectiveness index (> 70% improvement) Show forest plot	1		Odds Ratio (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 16. Metoclopramide vs. domperidone

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Comparison 17. L‐5‐hydroxytryptophan vs. pizotifen

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Headache index Show forest plot	1		Std. Mean Difference (IV, Fixed, 95% CI)	Totals not selected

2 Pain total index Show forest plot	1		Std. Mean Difference (IV, Fixed, 95% CI)	Totals not selected

3 Adverse events Show forest plot	1		Risk Difference (M‐H, Fixed, 95% CI)	Totals not selected

Comparison 17. L‐5‐hydroxytryptophan vs. pizotifen

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