The Impact of Vitamin D Supplementation to Topiramate Therapy on Pediatric Migraine Prophylaxis.

There is still a need for more studies to evaluate the role of vitamin D in pediatric migraine prophylaxis. We aimed to evaluate the effects and safety of vitamin D supplementation to topiramate on pediatric migraine. A double-blinded prospective clinical trial was conducted on 5- to 14-year-old children with migraine. They were randomly assigned in a 1:1 ratio into 2 groups, one with vitamin D supplementation (the supplementation group) and the other without vitamin D supplementation (the placebo group). The supplementation group received topiramate plus one 5000-IU dose of vitamin D daily for 4 months. The placebo group received topiramate with a placebo capsule without any effective substances. The primary outcomes were a monthly frequency of headache attacks, a good response to intervention, and reduction in migraine severity, duration, and disability before and after treatment. Fifty-six children completed the trial. Vitamin D supplementation to topiramate was more effective than the placebo group in the reduction of monthly frequency (6231.31 vs 9792.24 times,  = .01) and disability score for migraines (17 566.43 vs 25 187.65,  = .04). A good response was observed in 76.13% of patients in the vitamin D supplementation group and 53.5% of patients in the placebo group, and vitamin D supplementation was significantly more effective than placebo ( = .01). Side effects were observed in 13.3% and 20% of the intervention group and placebo groups, respectively,  = .5. Vitamin D supplementation in pediatric migraine prophylaxis could be a well-tolerated, safe, and effective strategy.