Pharmacological Treatment of Headache and Comorbidities

The term “headache” encompasses primary conditions and those secondary to other illnesses. This chapter describes the pharmacotherapy of primary headaches in children affected by additional diseases. As in the adult population, the most common primary headaches in children are migraine and tension-type headaches. Overall, the international prevalence of migraine among children and adolescents is in the range of 7.7–9.1%. Migraines are more prevalent in girls than boys when the age is 12 years or older, and migraine with aura is less common than migraine without aura [1–3]. Chronic migraine in US adolescents aged 12–17 years was 0.79, and 2% when including medication overuse [4]. Using a dedicated questionnaire, a population of children from 6 to 17 years of age exhibited the following 1-year prevalence: headache 89.3%; migraine 39.3%; and tension-type headache (TTH) 37.9%. Headache prevalence ≥15 days/month was 4.5% [5]. Cluster headache (CH) is a rare condition in adults and even rarer in children, with prevalence in the pediatric population estimated as 0.03–0.09% [6, 7]. In particular, attention is paid to pharmacotherapy of comorbidity of migraine with other diseases. Comorbidities affect treatment strategy and follow-up, especially when pharmacologic treatment is needed. In this chapter, we summarize pharmacologic options for migraine and tension-type headache treatment with specific attention to comorbidities.