What is the dose of Pizotifen for a 16 year old female with migrain?

Pizotifen is a prophylactic treatment taken every day in the hope of reducing frequency of migraine attacks. A good result is a 50% reduction in attack frequency. Start with 0.5mg every evening (10-12 hours before planning to get up). Start with 0.5mg; maximum is 4.5mg. It often causes weight gain and sleepiness. Some experts (e.g. NICE) regard it as of unproven efficacy, I think it can work well in young people but is less effective in adults. Treatment duration is 3-12 months. It is useful to keep a diary to assess response.

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