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Amitriptyline and topiramate are no better than placebo for childhood migraine
  1. Rebecca A Dalrymple1,
  2. Ian Wacogne2
  1. 1Department of Nephrology, The Royal Hospital for Children, Glasgow, UK
  2. 2General Paediatrics, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
  1. Correspondence to Dr Rebecca A Dalrymple, General Paediatrics, Birmingham Children's Hospital NHS Foundation Trust, Steelhouse Lane, Birmingham B4 6NH, UK; rebecca.dicks{at}

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Study question

Setting: 31 sites in the USA.

Patients: Children and adolescents aged 8–17 years with a diagnosis of migraine plus Pediatric Migraine Disability Assessment Score (PedMIDAS) indicating mild to severe disability and four or more headaches over the initial 28 day baseline period.

Intervention: 1 mg/kg/day amitriptyline versus 2 mg/kg/day topiramate versus placebo. There was a 28-day period initially before medication started to monitor baseline migraine frequency, the active medication was started and dose slowly increased for 8 weeks with 16-week maintenance period, to complete 24 weeks in total.

Outcomes: Primary outcome was relative reduction of 50% or more in number of headache days between the initial 28-day baseline period and the last 28-day period of the trial.

Secondary outcomes included headache disability (change in PedMIDAS score), reduction in the …

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  • Contributors RAD wrote the abstract, RAD and IW wrote the commentary.

  • Provenance and peer review Not commissioned; internally peer reviewed.