Nasal Spray May Treat Teen Migraines

A new study shows that a nasal spray used to treat adult migraines may also ease migraine pain for teens.

The spray, called Zomig, is approved for adult use. No prescription migraine medications have FDA approval for use in children, says Paul Winner, DO, FAAN, FAAP, who worked on the study.

Winner directs the Palm Beach Headache Center in West Palm Beach, Fla. He is also a clinical professor of neurology at Nova Southeastern University.

The study was funded by AstraZeneca, Zomig’s maker. It was presented in Philadelphia at the American Headache Society’s annual meeting. AstraZeneca is a WebMD sponsor.

The results are being reviewed by the FDA, Winner tells WebMD.

Read Web MD's "Get the Facts about Migraines."

Shorter Migraines in Youth

Headaches are common in children, but not all are migraine headaches.Between 11 percent and 19 percent of U.S. kids and teens have migraines. That’s 8 to 12 million youths, says Winner.

Migraines tend to be shorter in children and teens. “Adolescents tend to have their headaches in general anywhere from four to 12 hours,” says Winner. An adult migraine may last two to three days, he says.

However, migraines can be as disabling for children and teens as they are for adults, says Winner. “It is definitely affecting their lives,” says Winner.

The exact causes of migraines are unknown although they are related to changes in brain blood vessels and inflammation. Most children with migraines have family member that also suffer from migraines.

Read Web MD's "Prevention: The Future of Migraine Therapy."

Zomig vs. Placebo

Winner’s study compared Zomig nasal spray with a placebo spray. The 248 children were 12-17 years old (average age: 14 years). More than half were girls.

When a migraine first hit, everyone was first given the placebo. Teens have sometimes responded to placebos in past migraine studies, say the researchers.

If migraine pain remained after 15 minutes, the teens were given either Zomig or the placebo spray. No one knew which spray they got. Responses were checked for the next two hours.

Read Web MD's "Surgery for Migraines Looks Promising."

Study’s Results

A total of 171 teens weren’t helped by the first spray (the placebo). That meant they got a follow-up spray of Zomig or the placebo.

One hour after using the second spray, more Zomig users had gotten some migraine relief than those who got the placebo. Some teens started responding to Zomig within 15 minutes, say the researchers.

An hour after using Zomig, nearly a third of the Zomig users were free of migraine pain and half were able to resume normal activities. That’s compared with 10 percent who had pain relief after use of the placebo and 38 percent of who resumed normal activities.

After two hours, those numbers had risen to more than half (53 percent) of the Zomig group and 36 percent of the placebo group.

Side effects were few; none were serious, say the researchers. The most common side effect was change in taste sensation.

Zomig spray is “well tolerated” in adolescents with migraines and works quickly, say the researchers.

Read Web MD's "Herbal Extract May Help Prevent Migraines."

By Miranda Hitti, reviewed by Brunilda Nazario, MD

SOURCES: American Headache Society’s 47th Annual Scientific Meeting, Philadelphia, June 23-26, 2005. Paul Winner, DO, FAAN, FAAP, director, Palm Beach Headache Center, clinical professor of neurology, Nova Southeastern University. WebMD Medical Reference in collaboration with The Cleveland Clinic: “Your Child’s Headache.” News release, American Headache Society.