Efficacy of Amitriptyline as a Prophylactic Agent for Headaches in Pediatric Population (P04.171)

Abstract

Objective: To study the efficacy of Amitriptyline as a prophylactic agent for severe headaches in pediatric population under 21 years of age. Background Severe and frequent headaches is a major health issue among pediatric population causing significant disability and loss of quality of life, approximately 75% of adolescents and 25% of younger children experience headaches. This study aims to analyze the benefit of Amitriptyline as prophylaxis for prevention of headaches. Design/Methods: A retrospective chart review was performed on 576 pediatric headache patients who used Amitriptyline as headache prophylaxis and were seen in the pediatric neurology clinic of University of Missouri Hospital and Clinics from 2002-2011.Pertinent data such as patient demographics, headache diagnosis, medical history, Amitriptyline dosage, side effects and follow up duration were collected. Frequency and intensity of headaches at initiation of Amitriptyline and subsequent response to medication were recorded. Results: After exclusion of cases with poor documentation (including those with less than 3 months of follow up), there were 373 cases, comprising of 152 males (40.8%, mean age: 16.8) and 221 females (59.2%, mean age: 17.0). There were 306 patients with migraine headaches, 2 with tension headache, 49 with nonspecific headaches, and 16 patients with combination of 2 different headache diagnoses. Overall positive response was noted on 302 patients (81%) while 71 patients did not respond to medication (19%). Among patient who used Amitriptyline as mono-prophylaxis (150 patients), 124 (81%) patients had positive response, while 26 patients did not respond to medication. 41(11%) patients developed side effects from Amitriptyline. The common side effects were drowsiness and behavior changes. Conclusions: Amitriptyline is an efficacious, safe and well tolerated prophylactic agent for primary and secondary headaches in a pediatric population. Disclosure: Dr. Lim has nothing to disclose. Dr. Neelam has nothing to disclose. Dr. Patel has received research support from Eisai Inc. Dr. Thakkar has nothing to disclose. Dr. Bollu has nothing to disclose.