100 Migraine Drugs, A to Z: cyproheptadine

Cyproheptadine (Periactin) is one of the most popular drugs for the prevention of migraine headaches in children. Unfortunately, there is only one scientific study suggesting that cyproheptadine (4 mg per day) is as effective as propranolol (80 mg per day) for the prevention of migraines in patients aged from 16 to 53. There are no double-blind placebo-controlled trials of this drug in children and it is not likely that any will be conducted. It may not be such a big loss since most headache specialists do not consider it to be very effective.

Cyproheptadine is an anti-histamine, which means that if allergies contribute to migraines, it could help. It is available in 2 mg and 4 mg tablets and the dose ranges from 2 to 12 mg taken at bedtime. Some kids can tolerate as much as 8 mg taken three times a day. The drug is popular with pediatricians because it is fairly safe, even if it is not very effective. Common side effects are sleepiness, dizziness, dry mouth, and weight gain. Parents of very skinny kids and of kids who are finicky eaters may like the weight gain.