The efficacy of melatonin on disease relief in pediatrics with migraine treated with propranolol

Migraine is the most common cause of headaches in children. Understanding the factors that lead to exacerbation of headaches and their recovery plays an important role in controlling the disease. Melatonin is a hormone secreted by the pineal gland of the midbrain and some surrounding tissues. Research has shown that melatonin levels are lower in patients with migraines than in healthy people. Propranolol is a first-line drug in the prevention of migraine headaches. Therefore, in the present study, we investigated the effect of propranolol with melatonin on improving migraine intensity in patients without sleep disorders.

In this study, 49 children aged 5 to 15 years old who referred to the pediatric neurology clinic of Besat Hospital in Hamadan with a headache complaint who were diagnosed with migraine were eligible to receive migraine prevention medication, entered the study. Patients with migraine without sleep disturbance were randomly divided into two groups. The first group (control group) were treated with propranolol tablets daily and the second group (case group) were treated with propranolol and melatonin tablets daily. The course of treatment was at least 4 weeks, and if patients received the appropriate response, treatment continued up to three months. Data were analyzed using SPSS software version 16.

In this study, 49 patients with migraine (27 boys and 22 girls) who had the criteria to enter the study with an average age of 2.26 ± 10.12 entered the study. The highest frequency was related to the location of the headache in the frontal region and the quality of the headache of the multiplier type. It took about 1.5 years between the onset of the headache and the patientschr('39') visit to the doctor. The results of this study showed that the most irritating factor was school-related headaches and stress. The difference in the mean number of monthly headaches until the first month of treatment was not significant between the two groups, but after another three months of medication, the second group (propranolol and melatonin) surpassed the first group (propranolol) and decreased further in the number of monthly headaches

 According to the results of this study, propranolol alone can be considered as an effective drug for the treatment of various migraine headaches in children, but the results showed that melatonin consumption, especially with a duration of use of more than one month, according to the regulation of the sleep cycle and Awakening, if combined with propranolol, can be both more effective in reducing patientschr('39') headaches and improving treatment satisfaction.