© 2025 MJH Life Sciences™ and Patient Care Online. All rights reserved.
Zonisamide Shows Promise for Hard-to-Treat Migraine in Children, Adolescents
While the data on zonisamide efficacy for migraine in youths is preliminary, all study participants experienced a 66% reduction in headaches after 1 month of treatment.
Zonisamide, an antiseizure medication, may help prevent migraine attacks in children and adolescents, according to preliminary research to be presented at the American Academy of Neurology's (AAN) 77th Annual Meeting, April 5-9, 2025, in San Diego, CA. A review of health records from one institution found that children and teens with difficult-to-treat migraine prescribed zonisamide experienced a reduction in monthly headache days, with the greatest benefit seen after at least 2 months of use, according to a news release from the AAN.1
"Migraine disease is debilitating and can lead to kids having to miss school and other activities," lead author Anisa Kelley, MD, of Northwestern University Feinberg School of Medicine, said in the news release. "Currently, there is only one FDA-approved migraine preventative medication for this age group. Our results are encouraging, showing zonisamide may be another option for reducing migraine attacks."1
The study included 256 pediatric patients diagnosed with migraine and prescribed zonisamide as a preventative therapy. More than one-quarter of the youths (28%) had migraine identified as difficult to treat, defined for the study as having unsuccessful response to at least 2 previous medications Researchers recorded headache frequency before and after treatment initiation. They then divided the participants into subgroups based on duration of zonisamide treatment before attending a follow-up clinic appointment—after 1 month, within 2 to 6 months, and after 6 months.1
The median number of headache days per month for all of the participants dropped from 18 to 6 at the first follow-up visit. The greatest reduction was recorded among youth seen for follow-up within 2 to 6 months, with a median decrease of 6 headache days per month, according to the AAN. The data also suggested zonisamide efficacy across migraine severity.1
Current research indicates that up to 2.5% of children younger than 7 years have had a migraine. By the age of 10, the proportion doubles to approximately 5% who have experienced migraine. The prevalence of migraine continues to increase through childhood. Estimates are that 10% of children aged 5 to 15 years experience migraine, and 28% of teenagers have had a migraine.2
"It's very exciting that we may have an effective way to treat difficult migraine disease in children and teens, however it's important to note that our study did have limitations," Kelley said. "For instance, our study did not compare people taking the medication to people who did not take the medication. Future studies are needed with control groups to confirm our results."1
The study was funded by the Stanley Manne Children's Research Institute at Ann & Robert H. Lurie Children's Hospital of Chicago.
