Headaches in over 12s: diagnosis and management

Recommendation ID: CG150/2
Question: Pizotifen to prevent recurrent migraine:- Is pizotifen a clinically and cost effective prophylactic treatment for recurrent migraine?
Any explanatory notes (if applicable): Why this is important:- There are few data to inform guidance on the prevention of migraine in children and young people. Pizotifen is a popular treatment for migraine prevention in the UK, especially in children and young people. It has been in use since the 1970s and appears to be well tolerated. Inadequate evidence was found in the review for this guideline for the effectiveness of pizotifen in the prophylaxis of migraine. A double-blind RCT either head-to-head with best available treatment, or placebo controlled, is needed to assess the clinical and cost effectiveness of pizotifen in young people aged under 18 and adults. The trial should enrol people aged under 18 and adults. The definition of migraine used should be that in the International classification of headache disorders II or this guideline. Outcomes should include change in patient-reported migraine days, responder rate and incidence of serious adverse events. If pizotifen is shown to be effective, it will widen the range of therapeutic options, in particular for young people in whom recommended medications are ineffective or not tolerated.

Source guidance details

Is this a recommendation for the use of a technology only in the context of research?	No
Is it a recommendation that suggests collection of data or the establishment of a register?	No
Last Reviewed	02/10/2012