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Treating migraines in adolescents
For adolescents with infrequent migraines (with or without aura), these medications can be useful:
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Analgesics: pain-relieving medications (remember that aspirin is dangerous in children)
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Antiemetics: medications that relieve nausea and vomiting
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Sedatives: medication that helps a patient sleep (sleep relieves migraine)
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Abortive medications including:
--Triptans (Imitrex, Zomig, Amerge, Maxalt, Axert, Frova, and Relpax)
--DHE-45 , given nasally, subcutaneously, or intravenously
--A combination medication (Midrin)
--Ergotamine tartrate and caffeine (Cafergot)
- A combination of symptomatic and abortive medications
Sedatives and abortive medications aren't approved by the FDA for use in people under age 18.
For adolescents with frequent migraines, these medications (not FDA approved for kids) can be tried:
- Preventive medicines such as propranolol, tricyclic antidepressants, calcium channel blockers, or anticonvulsants
- A combination of abortive and symptomatic medications
When headaches--and especially migraine headaches--last longer than 24 hours and other medications have been unsuccessful in managing the attacks, medication administered in an "infusion suite" can be considered. An infusion suite is a designated set of rooms at a hospital or clinic that is monitored by a nurse and where intravenous drugs are administered. The intravenous drugs are usually able to end the migraine attack. Patients' length of stay at the infusion suite can range from several hours to all day.
For adolescents with severe migraines that do not respond to other medications and last more than 24 hours, these abortive medications (not FDA approved for kids) can be prescribed:
- Triptans, given by injection
- DHE-45, given nasally, subcutaneously, or by intravenously
- Anticonvulsants, given by infusion
- Sedatives, given by infusion
- Antiemetics, given by infusion
- Others, such as magnesium or nonsteroidal anti-inflammatory drugs
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