Melatonin for Adolescent Migraine Prevention Study

Melatonin for Adolescent Migraine Prevention Study (The MAP Study).

Status

Terminated

Phases

Phase 2

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT03150797

Acronym

MAP

Enrollment

Registered

2017-05-12

Start date

2017-08-02

Completion date

2019-12-01

Last updated

2023-10-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Migraine

Keywords

UCSF, UCLA, melatonin, migraine, headache

Brief summary

This will be a randomized, multi-site double-blind placebo-controlled trial of melatonin (2 different dosing arms) vs. placebo for migraine prevention in adolescents. We intend to enroll approximately 210 participants over 15 months at two sites: UCLA and UCSF. The duration of participation for each participant will be 4 months.

Detailed description

Participation includes 16 weeks of daily headache diary recording and taking the study pill every night, 1-2 hours before bed. Aside from the initial 1 hour enrollment visit, all remaining study procedures will be completed from home. During the enrollment visit, history of migraine, questionnaires, a neurologic and physical exam (including weight, blood pressure, pulse, and respiratory rate) will be performed. Girls who have had their first period will undergo a urine pregnancy test and will be instructed to use birth control if they are sexually active. For the first 8 week phase, participants will be instructed to take one study pill every night, 1-2 hours before bedtime and complete a daily headache diary from a smartphone. Phone call check-ins will occur at week 4 and week 8. After the first 8 weeks of the study, participants who are eligible for the second phase of the study will be notified by study staff and will be sent the next set of study pills. Again, participants will be instructed to take the study pill every night, 1-2 hours before bedtime and complete a diary entry every evening. Phone call check-ins will occur at week 12 and week 16. At the final 16 week phone call, additional questionnaires and study completion feedback will be collected.

Interventions

DRUGMelatonin

Melatonin

DRUGPlacebo oral capsule

Placebo

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

PREVENTION

Masking

DOUBLE (Subject, Caregiver)

Eligibility

Sex/Gender

ALL

Age

10 Years to 17 Years

Healthy volunteers

Inclusion criteria

1. Age 10-17-inclusive 2. Weight ≥40 kg, so as not to require mg/kg based dosing 3. Meets International Classification of Headache Disorders III beta1 criteria for migraine in children/adolescents (international standard diagnostic criteria for research) 4. Lives in the state of California- to allow shipping of study medication from our pharmacy 5. Has at least one parent who speaks English-in order to ensure good communication with study team by phone 6. Has daily access to a smartphone in order to provide daily headache diary data 7. A Parent/Guardian consents and the adolescent is cognitively capable of giving assent to participate 8. Either not on a migraine preventive medication, or if on one the dose has been stable for at least 4 weeks prior to enrollment, or are willing to wait to start the study until they have reached a stable dose for 4 weeks 9. Willing to not use OTC melatonin or change migraine preventives during the trial 10. Has ≥1 headache day per week, or 4-28 days of headache in a 28-day period Episodic headaches have been present for a minimum of 6 months-This lowers the likelihood of a secondary cause of headaches

Exclusion criteria

1. Continuous headache 2. History of seizures/epilepsy 3. Pregnant/lactating 4. Concomitant opioid or barbiturate overuse, wherein overuse is defined as ≥4 days per month of barbiturate containing compounds, ≥10 days per month of opioid containing compounds as these may impact sleepiness scales 5. If in the investigator's opinion there is a medical or psychiatric concern that makes them think the participant should not participate 6. Inability to swallow pills after teaching and practice History of nocturnal asthma, as evidenced by a having a diagnosis of asthma and symptoms that manifest as nighttime awakening due to cough, wheeze, and/or shortness of breath Randomization Criteria: 1. Had 4-28 migraine/migrainous days in the 28-day period of weeks 5-8 of single-blind placebo treatment phase, but not continuous headache. 2. At least 80% compliance with headache diary (i.e. at least 23 headache diary days) during weeks 5-8 of single-blind placebo treatment phase.

Design outcomes

Primary

Measure	Time frame	Description
Mean Migraine/Migrainous Days in Weeks 5-8 of Randomized Treatment Phase in Melatonin Treated Participants vs. Placebo.	weeks 5-8 of randomized treatment phase	Mean migraine/migrainous days in weeks 5-8 of randomized treatment phase in melatonin treated participants vs. placebo. (Ultimately, as the data were not normally distributed, medians were more appropriate).

Secondary

Measure	Time frame	Description
Mean Migraine/Migrainous Days in Weeks 5-8 of Randomized Treatment Phase in Melatonin 3 mg vs. Placebo.	Weeks 5-8 of randomized treatment phase.	Mean migraine/migrainous days in weeks 5-8 of randomized treatment phase in melatonin 3 mg vs. placebo.
Mean Migraine/Migrainous Days in Weeks 5-8 of Randomized Treatment Phase in Melatonin 6 mg vs. Melatonin 3 mg.	Weeks 5-8 of randomized treatment phase.	Mean migraine/migrainous days in weeks 5-8 of randomized treatment phase in melatonin 6 mg vs. melatonin 3 mg.
Change in Mean Migraine/Migrainous Days From Weeks 5-8 of Single-blind Treatment Phase to Weeks 5-8 of Randomized Treatment Phase for Each Group.	Weeks 5-8 of single-blind treatment phase to weeks 5-8 of randomized treatment phase.	Change in mean migraine/migrainous days from weeks 5-8 of single-blind treatment phase to weeks 5-8 of randomized treatment phase for each group. (Medians reported when data were not normally distributed).
Mean Migraine/Migrainous Days in Weeks 5-8 of Randomized Treatment Phase in Melatonin 6 mg vs. Placebo.	Weeks 5-8 of randomized treatment phase.	Mean migraine/migrainous days in weeks 5-8 of randomized treatment phase in melatonin 6 mg vs. placebo. (Medians reported when data were not normally distributed).
Mean CASQ (Cleveland Adolescent Sleepiness Questionnaire) Score in Weeks 5-8 of Randomized Treatment Phase in Melatonin Treated Group vs. Placebo, and in Each of the Three Pair-wise Group Comparisons.	Weeks 5-8 of randomized treatment phase.	Mean CASQ score in weeks 5-8 of randomized treatment phase in melatonin treated group vs. placebo, and in each of the three pair-wise group comparisons. The CASQ is a 16-question instrument that uses Likert-like responses and has a score range from 16-80; higher scores indicate greater sleepiness
Number of Days Acute Medication is Used in Weeks 5-8 of Randomized Treatment Phase in Melatonin Treated Group vs. Placebo, and in Each of the Three Pair-wise Group Comparisons.	Weeks 5-8 of randomized treatment phase.	Number of days acute medication is used in weeks 5-8 of randomized treatment phase in melatonin treated group vs. placebo, and in each of the three pair-wise group comparisons. This refers to the number of days that medication for the acute treatment of headache was used during the time frame.
Number of Headache Days in Weeks 5-8 of Randomized Treatment Phase in Melatonin Treated Group vs. Placebo, and in Each of the Three Pair-wise Group Comparisons.	Weeks 5-8 of randomized treatment phase.	Number of headache days in weeks 5-8 of randomized treatment phase in melatonin treated group vs. placebo, and in each of the three pair-wise group comparisons. This refers to number of headache days during the time period--regardless of whether they were migraine or not.
Mean PedMIDAS (Pediatric Migraine Disability Assessment Score) in Weeks 5-8 of Randomized Treatment Phase in Each Melatonin Treated Group vs. Placebo, and in Each of the Three Pair-wise Group Comparisons.	Weeks 5-8 of randomized treatment phase.	Mean PedMIDAS (headache related disability score) in weeks 5-8 of randomized treatment phase in each melatonin treated group vs. placebo, and in each of the three pair-wise group comparisons. PedMIDAS is a 6 question instrument for measuring headache related disability in children and adolescents.

Countries

United States

Participant flow

Participants by arm

Arm	Count
Melatonin 3mg Melatonin 3mg Melatonin: Melatonin	14
Melatonin 6mg Melatonin 6mg Melatonin: Melatonin	14
Placebo Oral Capsule Placebo Placebo oral capsule: Placebo	14
Enrolled in Single-blind Phase, But Did Not Randomize. Placebo This group constitutes those who enrolled in the study and entered the single-blind phase, but did not go on to the double-blind randomized phase.	30
Total	72

Baseline characteristics

Characteristic	Melatonin 6mg	Placebo Oral Capsule	Enrolled in Single-blind Phase, But Did Not Randomize.	Melatonin 3mg	Total
Age, Categorical <=18 years	14 Participants	14 Participants	30 Participants	14 Participants	72 Participants
Age, Categorical >=65 years	0 Participants	0 Participants	0 Participants	0 Participants	0 Participants
Age, Categorical Between 18 and 65 years	0 Participants	0 Participants	0 Participants	0 Participants	0 Participants
Age, Continuous	14.3 years STANDARD_DEVIATION 2.4	15.4 years STANDARD_DEVIATION 1.5	14.4 years STANDARD_DEVIATION 1.7	15.2 years STANDARD_DEVIATION 2.1	15.0 years STANDARD_DEVIATION 2
Race (NIH/OMB) American Indian or Alaska Native	0 Participants	0 Participants	0 Participants	0 Participants	0 Participants
Race (NIH/OMB) Asian	1 Participants	0 Participants	1 Participants	1 Participants	3 Participants
Race (NIH/OMB) Black or African American	0 Participants	0 Participants	1 Participants	1 Participants	2 Participants
Race (NIH/OMB) More than one race	0 Participants	0 Participants	0 Participants	0 Participants	0 Participants
Race (NIH/OMB) Native Hawaiian or Other Pacific Islander	1 Participants	0 Participants	1 Participants	0 Participants	2 Participants
Race (NIH/OMB) Unknown or Not Reported	2 Participants	5 Participants	7 Participants	3 Participants	17 Participants
Race (NIH/OMB) White	10 Participants	9 Participants	20 Participants	9 Participants	48 Participants
Region of Enrollment United States	14 participants	14 participants	30 participants	14 participants	42 participants
Sex: Female, Male Female	12 Participants	11 Participants	16 Participants	10 Participants	49 Participants
Sex: Female, Male Male	2 Participants	3 Participants	14 Participants	4 Participants	23 Participants

Adverse events

Event type	EG000 affected / at risk	EG001 affected / at risk	EG002 affected / at risk
deaths Total, all-cause mortality	0 / 14	0 / 14	0 / 14
other Total, other adverse events	2 / 14	3 / 14	3 / 14
serious Total, serious adverse events	0 / 14	0 / 14	0 / 14

Outcome results

Primary

Mean Migraine/Migrainous Days in Weeks 5-8 of Randomized Treatment Phase in Melatonin Treated Participants vs. Placebo.

Mean migraine/migrainous days in weeks 5-8 of randomized treatment phase in melatonin treated participants vs. placebo. (Ultimately, as the data were not normally distributed, medians were more appropriate).

Time frame: weeks 5-8 of randomized treatment phase

Arm	Measure	Value (MEDIAN)
Melatonin 3mg	Mean Migraine/Migrainous Days in Weeks 5-8 of Randomized Treatment Phase in Melatonin Treated Participants vs. Placebo.	2 days
Melatonin 6mg	Mean Migraine/Migrainous Days in Weeks 5-8 of Randomized Treatment Phase in Melatonin Treated Participants vs. Placebo.	2 days
Placebo Oral Capsule	Mean Migraine/Migrainous Days in Weeks 5-8 of Randomized Treatment Phase in Melatonin Treated Participants vs. Placebo.	2 days

Secondary

Change in Mean Migraine/Migrainous Days From Weeks 5-8 of Single-blind Treatment Phase to Weeks 5-8 of Randomized Treatment Phase for Each Group.

Change in mean migraine/migrainous days from weeks 5-8 of single-blind treatment phase to weeks 5-8 of randomized treatment phase for each group. (Medians reported when data were not normally distributed).

Time frame: Weeks 5-8 of single-blind treatment phase to weeks 5-8 of randomized treatment phase.

Arm	Measure	Value (MEDIAN)
Melatonin 3mg	Change in Mean Migraine/Migrainous Days From Weeks 5-8 of Single-blind Treatment Phase to Weeks 5-8 of Randomized Treatment Phase for Each Group.	2 days
Melatonin 6mg	Change in Mean Migraine/Migrainous Days From Weeks 5-8 of Single-blind Treatment Phase to Weeks 5-8 of Randomized Treatment Phase for Each Group.	-1 days
Placebo Oral Capsule	Change in Mean Migraine/Migrainous Days From Weeks 5-8 of Single-blind Treatment Phase to Weeks 5-8 of Randomized Treatment Phase for Each Group.	0 days

Secondary

Mean CASQ (Cleveland Adolescent Sleepiness Questionnaire) Score in Weeks 5-8 of Randomized Treatment Phase in Melatonin Treated Group vs. Placebo, and in Each of the Three Pair-wise Group Comparisons.

Mean CASQ score in weeks 5-8 of randomized treatment phase in melatonin treated group vs. placebo, and in each of the three pair-wise group comparisons. The CASQ is a 16-question instrument that uses Likert-like responses and has a score range from 16-80; higher scores indicate greater sleepiness