Childhood Migraines: Prevention, Treatment and Medications 

Written by Holly Hazen

When I hear about childhood migraines, it breaks my heart. I struggle with them as an adult and I just don’t even want to imagine young children having migraines. This area for kids needs more clinical studies and research.

On this page you will find a list of suitable prevention treatments and recently approved medications to discuss with your doctor.

You may like to read these other related articles before you get to the heavy guns of medications:

Migraines in children

Headaches in children, the difference

Abdominal migraines and stomach migraines

Abdominal migraine treatment

• An Easy Migraine Relaxation Technique

Biofeedback and migraines

• and help manage the emotional side effects of migraine in children

Treatment for Childhood Migraines

The initial treatment for childhood migraines can vary substantially as children experience, in most cases, about two to four hours of migraine. If they rest at their first sign of attack, they may resolve themselves quickly and unaided.

If not, however you need to see your doctor. S/he will need to take every other factor into consideration, along with their age and weight.

Here is a list of the most commonly used medications:

Childhood Migraines

• Both Reglan® (metoclopramide) and Phenergan® (promethazine) are used to combat nausea. They also alleviate migraine symptoms as well. 

• NSAIDS: Ibuprofen (OTC) or naproxen (by prescription).

• The most effective family of migraine medications are the Triptans.

Both Maxalt and Axert are approved for children and teenagers.

Children who get migraines that are over 6 years old can be prescribed Maxalt® (Rizatriptan).

Teenage children from the age of 12 can be prescribed Axert® (Almotriptan malate). 

The nasal form of Imitrex, has also been commonly used for childhood migraines with good success rates.

Imitrex is best taken with food as it can add to the nausea and cause vomiting. So, if vomiting is not occurring, the triptan should be taken at the earliest sign of attack.

Never Take Another Pill Or Pain Killer If It Or They Are Vomited Up.

Taking another tablet, pain killer, abortive, or additional medication dose after throwing up is not recommended.

This can cause accidental overdose.

Please be aware of this fact and check with you doctor about what to do in this case with your child and their medications.

Migraine Prevention in Children and Adolescents

Terri Robert, in her book Living Well with Migraine Disease and Headaches, cites a team from the American Academy of Neurology Quality Standards Subcommittee and the Practice Committee of the Child Neurology Society that researched peer reviewed medical journals on pharmacological treatment of Migraine Disease in Children and Adolescents.

These recommendations for migraine prevention in children and adolescents were found:

Flunarizine - a calcium channel blocker, the study found probable effectiveness.

Side Effects: ”Drowsiness, weight gain, nausea, heartburn, dry mouth or anxiety may occur as your body adjusts to the medication” ( Always, with any side effects it is important to tell your doctor immediately.

Other things to watch for are: hives or a “skin rash, depression, muscle aches, tremor, difficulty moving, abnormal or uncontrolled movements (especially of the face or mouth)”.

There are also numerous precautions and warnings of drug interactions if your child is also taking over the counter (OTC) or other medications like: “sedatives, anti-anxiety medications, muscle relaxants, tranquilizers, or anti-seizure medications”.

****Ah! I see this drug is not available in the United States any longer - so just a warning here now *****

Most medications come with overdose information. Always watch for unusual changes in your child’s behavior, speech and posture. This includes confusion, unusual drowsiness, and a rapid or increased pulse rate. Have your local poison control center phone number somewhere handy in case of emergencies. Your pharmacist will have emergency numbers available as will your doctor.

US residents can call the US national poison hotline at 1-800-222-1222. Other residents of other countries should call the local poison control center directly or click on this link for the World Health Organization's (WHO) world directory of poison centers.

P.S. Preventative therapies must be taken daily.

Interestingly, the review found insufficient or conflicting evidence to make recommendations for using any of these for migraine prevention in children and adolescents:

• Depakote (Divalproex Sodium)
• Desyrel (Trazodone)
• Elavil (Amitriptyline)
• Inderal (Propranolol)
• Keppra (Levetiracetam)
• Nimotop (Nimodipine)
• Periactin (Cyproheptadine)
• Sandomigran (Pizotifen)
• Topamax (Topiramate)

So, out of all that, Flunarizine is the only one to possibly be considered in this review! However, there have been successful results with all of them in some cases with children. Inderal, Periactin and Depakote are all commonly used with successful results. So you might be back to trial and error depending on the desperation of finding effective pain relief for your child.

Almost every study I read says that more research must be done. This is one area that is understudied and more clinical trials are needed to determine the efficacy of these medications on children. Mind you, I wouldn’t want experiments with these kinds of medications being done on my child, who knows what long term effects it might have.

Triptan Medications for Teenagers Over 12

I just wanted to share some more links on this good news since the FDA approved Axert® (Almotriptan malate) for use in children over the age of 12.

Please click here for the US prescribing information details from

Abortive therapies – more specifically triptans - were not previously recommended for migraineurs under the age of eighteen. However, “Sumatriptan (Imitrex / Imigran) nasal spray was found to be effective and should be considered effective treatment of acute Migraine attacks in adolescents” over the age of 12.

Effective Treatment for Under 12's

Maxalt® (Rizatriptan) has recently been approved for the use of children from the age of 6. Finally some fantastic advances in the Pediatric area. Please click on these links for more details on the US prescribing information and patient information from

The homeopathic remedy Gelstat Migraine is also an option for childhood migraines and adolescents. It has feverfew and ginger in it and has a unique sublingual (under the tongue) delivery system. The directions are to put it under the tongue and wait 60 seconds before swallowing it. This system bypasses the digestive system which is upset and not functioning in the initial stages of a migraine attack.

The studies show it has been effective in 48-83% of treatments. It sure sounds worth a try. You can buy it at your local pharmacy.

These are just a few medications, at time of writing, that exist. I have listed them for you to print out or record and then discuss with your physician.

For a more alternative approach to treat childhood migraines read home remedies for migraines in children.

Guided meditation CD's will help them to drift off and fall asleep.

Childhood Migraines Resources::

1. Robert, Teri (2009) Living Well with Migraine Disease and Headaches. Harper Collins Publishers: NY.

2. Senelick, R. MD. at Web MD (2015) What Are Abdominal Migraines in Children and Adults. Available [Online] Accessed June 22, 2016. 

3. (2012) Flunarizine Oral Capsule. [Online], Available at: Accessed June 2016.

4. (2015) Adolescent and Teenage Migraines. [Online], Available at:  Accessed June 22, 2016.

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