Ondansetron a potential answer to paediatric migraines

Ondansetron is effective for migraines in children, a new study has found.

Researchers conducted a retrospective chart review of 98 encounters (80 children) who presented to the paediatric emergency department with migraines. Of the episodes, 42 were managed with ondansetron, 22 were treated other antidopaminergic drugs and 34 received no antiemetic medications. The primary outcome was treatment success, defined as a drop in verbal pain score by at least half.

Initial pain score was significantly higher in the ondansetron vs no antiemetic group (8.21±2.09 vs 7.22±2.00; p=0.03).

In all three treatment groups, the primary outcome occurred comparably frequently. For instance, 90 percent of those who were given ondansetron showed a drop of at least 50 percent in the verbal pain score. The corresponding percentages in the antidopaminergic and no antiemetic groups were 91 percent and 94 percent, respectively. Reduction in pain was significant in all groups (p<0.001).

Emergency department revisit rate was set as a secondary outcome. Two patients in the no antiemetic control group had to return, while none in both ondansetron and antidopaminergic groups revisited the hospital. Opioids were needed in 9.5 percent, 4.5 percent and none of the patients in the ondansetron, antidopaminergic and no antiemetic groups, respectively.

“Further prospective studies are needed to confirm our findings. Moreover, comparing the efficacy in routes of administration of ondansetron would be of interest, especially in the paediatric population, in whom conservative placement of intravenous lines is practiced,” said the researchers, adding that confirmation in a more diverse population is also needed.