If your child has a headache, there a different treatments available.

What medicines are used to treat headaches in children?

There are 3 types of medicines to treat headaches in children. These are used in the moment they have a headache. These medicines are called rescue medicines. Rescue medicines don’t prevent headaches but can relieve them. They include:

• pain relievers (analgesics)
• anti-nausea medicines(anti-emetics)
• antimigraine medicines (triptans)

Pain relievers

Pain relievers (analgesics) work well for migraines and tension headaches, especially when they are taken as soon as a headache starts (within 5 to 20 minutes). Don’t give your child pain relievers more than 2 or 3 times a week if they need to use them regularly. Pain relievers can cause headaches (analgesic rebound headaches) if they are taken regularly for weeks or months.

There are 2 main types of pain relievers to treat headaches in children – non-steroidal anti-inflammatory drugs (NSAIDs) and anti-fever drugs (anti-emetics).

The following are non-steroidal anti-inflammatory drugs (NSAIDs):

• Ibuprofen (such as Advil or Motrin) is the most common over-the-counter NSAID used to treat headaches in children. NSAIDs don’t often cause side effects other than stomach upset (nausea) unless it is taken regularly.
• Naproxen (such as Aleve) is an over-the-counter, NSAID used to treat migraines. We recommend using a naproxen if ibuprofen or acetaminophen doesn’t work. Naproxen can cause stomach problems if it’s used regularly. Don’t give your child naproxen more than 3 times a week.
• Ketorolac (Toradol) is an NSAID used to treat moderate to severe pain. The most common side effect is abdominal pain or ulcers if it is used regularly.
• Diclofenac (Cambia) is an NSAID used to treat moderate to severe pain and migraine headaches. The most common side effect is abdominal pain if it is used regularly.

Acetaminophen, such as Tylenol, is a type anti-fever drug that is often used to treat headaches. It usually doesn’t cause any side effects.

Talk to your child’s healthcare provider if you have questions about pain relievers for headaches.

Anti-nausea medicines

Some children may have nausea or vomiting along with a headache. Anti-nausea medicines (anti-emetics) help prevent nausea and vomiting. They also help headache pain medicines work better. The following anti-nausea medicines are sometimes used with pain relievers to treat headaches:

• Dimenhydrinate (Gravol), lessens nausea and vomiting. It may cause children to feel sleepy or have a dry mouth or blurred vision.
• Metoclopramide (Maxeran; Metonia), can help pain relievers work faster to relieve pain. It also helps to lessen nausea and vomiting. Side effects include feeling tired (fatigue) and muscle spasms.
• Ondansetron (Zofran) prevents nausea and vomiting. Side effects include diarrhea, constipation, feeling sleepy, and being itchy.

Antimigraine medicines

Antimigraine medicines (triptans) are sometimes used to treat migraines when pain relievers don’t work). They change chemicals in the brain that can cause headaches and pain. It’s important for your child to take an antimigraine medicine as soon as the migraine starts. But they shouldn’t be taken regularly to treat headaches or to prevent headaches.

Almotriptan (Axert) is the only antimigraine medicine approved in Canada to treat migraines in children between ages 12 and 17. Side effects include nausea, feeling weak, dizzy, tired, and having chest tightness.

The following antimigraine medicines are considered safe, but are not officially approved for children because they haven’t been studied with this age group.

• rizatriptan (Maxalt)
• sumatriptan (Imitrex)
• zolmitriptan (Zomig)

Your child shouldn’t take triptan medications if they:

• have high blood pressure.
• take certain antidepressant medications such as monoamine oxidase (MAO) inhibitors.
• have hemiplegic headaches (this type of headache prevents movement on or affects one side of the body) or basilar migraines (this type of headache causes dizziness, vision changes, and trouble with body movements).

Talk to your healthcare provider about whether triptans are right for your child.

Are there other ways to treat headaches in children?

There is some evidence that complementary medicine may help to treat headaches in children. Medicines and complimentary medicine can be used together to help manage headaches. Research into complementary medicine and headaches is just starting. Researchers are studying the following to help control headaches in children:

• biofeedback
• acupuncture
• guided imagery
• relaxation therapy
• herbs, minerals, and vitamins
• chiropractor (but don’t have them do any neck manipulation)
• massage therapy (but not cranial therapy)
• aromatherapy and therapeutic-grade essential oils such as peppermint for pain and lavender for nausea

Find out more about complementary medicine.

Talk to a nurse, social worker, psychologist, or your child’s doctor about other ways to treat headaches in children. They can help you and your child:

• find out what may be causing the headaches
• learn ways to lower stress and help manage it (if needed)
• use cognitive behavioral therapy (a type of counselling that helps people find ways to change negative thoughts and behaviours) as a part of headache treatment
• learn self-hypnosis to help manage pain