The effect of prophylactic drugs in pediatric and adolescent migraine compared to placebo

Abstract

Migraine is a common neurological disorder in children and adolescents, with a prevalence of 11%. It causes functional impairment and a reduced quality of life, and may lead to episodes of chronic migraine; therefore, pharmacological prophylaxis is a fundamental part of a long-term treatment plan aimed at reducing the recurrence and intensity of migraine episodes. The objective of this review article is to determine, in pediatric and adolescent patients with migraine, the effect of a pharmacological prophylactic approach compared to placebo on the recurrence of migraine episodes. To this end, a literature review was conducted in the following databases: ScienceDirect, PubMed, and SciELO; open-access articles containing the MeSH terms “migraine,” “prophylaxis,” and “pediatric population” were included, across the categories of review articles, original articles, and meta-analyses in English and Spanish, published between 2019 and 2025. It is concluded that migraine prophylaxis in the pediatric population is in the early stages of research, with limitations in the evaluated studies that make it difficult to achieve statistical significance for all the treatment options described; therefore, more evidence is needed to reach a consensus on the management of this condition.