From the Guidelines
Aspirin should not be used to treat migraines in children under 16 years of age. This is due to the risk of Reye's syndrome, a rare but potentially fatal condition that causes swelling in the liver and brain, associated with aspirin use in children and teenagers with viral illnesses, particularly influenza and chickenpox 1. For children with migraines, safer alternatives include ibuprofen, which is recommended as first-line medication, at a dose appropriate for body weight 1.
Key Considerations
- The evidence base for medication therapy in children and adolescents is confounded by a high placebo response in clinical trials 1
- For adolescents aged 12–17 years, multiple NSAIDs and triptans have been approved for acute treatment of migraine, and some evidence indicates that nasal spray formulations of sumatriptan and zolmitriptan are the most effective 1
- In practice, propranolol, amitriptyline and topiramate are used for preventive treatment, although their effectiveness in children and adolescents has not been proven in clinical trials 1
Treatment Approach
- Bed-rest alone might suffice in children with attacks that have a short duration
- When needed, ibuprofen is recommended as first-line medication, at a dose appropriate for body weight 1
- Domperidone can be used for nausea in adolescents aged 12–17 years, although oral administration is unlikely to prevent vomiting 1
- Parents should always consult with a pediatrician or neurologist before giving any medication to treat migraines in children, as proper diagnosis and individualized treatment plans are essential for managing childhood migraines effectively and safely.
From the FDA Drug Label
■ do not take more than directed adults and children 12 years and over ■ take 2 caplets every 8 hours while symptoms persist children under 12 years ■ ask a doctor ■ do not take more than 6 caplets in 24 hours, unless directed by a doctor The recommended age for using aspirin to treat migraines in children is 12 years and over. For children under 12 years, it is advised to ask a doctor before administering aspirin 2.
From the Research
Aspirin Use in Children for Migraine
- The provided studies do not specify the exact age at which aspirin can be used to treat migraines in children 3, 4, 5, 6, 7.
- However, it is mentioned that aspirin should be avoided in children under the age of 12 years due to the risk of Reye's Syndrome 5, 6.
- Reye's Syndrome is a serious, acute encephalopathy that has been linked with aspirin use in children and teenagers <18 years of age 6.
- The use of aspirin in children under 12 years old is not recommended, and health education about the possible risks of Reye's Syndrome needs to be improved 5.
- For children over 12 years old, high-dose aspirin (900-1300 mg) may be an effective and safe treatment option for acute migraine headaches, but this should be done under the guidance of a healthcare professional 3.
- It is essential to note that the treatment of migraines in children should be individualized, and the decision to use aspirin or any other medication should be made on a case-by-case basis, taking into account the child's medical history, age, and other factors 7.