Efficacy and safety of melatonin for migraine prevention in children and adolescents: a systematic review and meta-analysis
Abstract
Background: Migraine is known to be the most prevalent primary headache in pediatric and adolescent patients, affecting around 28% of teenagers. Besides this, only a limited number of prophylactic treatments have proven effective for these age groups. Melatonin, a hormone primarily produced by the pineal gland, plays an important role in the modulation of the circadian rhythm and has shown effectiveness in preventing migraines in adults in previous studies. However, its efficacy in younger patients remains uncertain. Objective: To assess the safety and efficacy of melatonin for migraine prophylaxis among children and adolescents. Methods: Pubmed, Scopus, Web of Science, and Cochrane databases were systematically searched for randomized controlled trials (RCTs) testing melatonin for migraine prevention in pediatric or adolescent populations. A random-effects model was used to calculate the mean differences (MDs) with 95% confidence intervals (CIs). Heterogeneity was determined using I² statistics. Efficacy was assessed based on headache frequency, while safety was evaluated by adverse events (AEs), including daily sleepiness, nausea, vomiting, worsened headache, worsened movement sensitivity, elevated heart rate, flu-like symptoms, constipation, fatigue, malaise, and fever. Statistical analysis was conducted using R, version 4.4.0. Results: We included 4 RCTs with 238 patients. The mean age ranged from 9.28 to 15.00 years, with a majority of female patients (55.9%). Compared…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 238 participants or records.
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