Pediatric Neurology Patients Use Alternative Medications for Sleep Disorders, Headache

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The most commonly reported neurologic disorders being treated with CAM were headache and epilepsy. Use of CAM was reported by 41.6% of respondents.
The most commonly reported neurologic disorders being treated with CAM were headache and epilepsy. Use of CAM was reported by 41.6% of respondents.

Pediatric neurology patients report statistically significant usage of complementary and alternative medications (CAM) in treating headaches, chronic fatigue, and sleep disorders, according to the results of a survey published in Pediatric Neurology.

However, many of the survey responders did not identify themselves as CAM users: only 17.4% admitted to using CAM to treat neurologic problems, even though follow-up questions revealed that 41.6% of patients actually recognized that they were using 1 or more types of CAM.

The use of CAM in pediatric neurology practice is estimated to be between 24% and 78%, varying widely among sites, and has become an area of increasing interest to providers of pediatric care. Because certain conditions such as autism-spectrum disorders or migraines may have a greater association with CAM use than other neurologic diseases, “it is … helpful for pediatric providers to understand how CAMs are being used in their specific community as well as in the larger population,” the authors wrote.

To assess the use of CAM in an outpatient pediatric neurology clinic, as well as family attitudes toward the effectiveness of CAM vs prescription medications, Daniel Kenney, MD, of the Mayo Clinic Department of Child and Adolescent Neurology in Rochester, Minnesota, and colleagues collected data by surveying 500 patients in a pediatric outpatient neurology clinic. In total, the researchers were able to analyze 327 completed surveys.

The most commonly reported neurologic disorders being treated with CAM were headache (39.1%) and epilepsy (32.7%). Use of CAM was reported by 41.6% (136/327) of respondents, with 54 reporting using 3 or more. For the question “Does your child take CAM to treat neurological problems?” only 17.4% (57/327) answered affirmatively.  

Sleep disorders (77.1% with sleep disorders used CAM vs 37.3% without sleep disorders, P<.0001), chronic fatigue (63.2% vs 38.8%, P=.005), and headache (50.8% vs 35.7%, P=.008) were associated with an increased prevalence of CAM use.

Sleep disorders continued to be the most common disorder reported by CAM users even after controlling for melatonin use (62.9%). While melatonin was the most commonly reported CAM, only 16 participants considered melatonin a CAM.   

Those who were less satisfied with their prescription medications were also more likely to use CAM, perhaps reflecting that their disorders were less easily managed than others. Most of the study participants (70.6%) felt that CAM was “at least slightly effective.” In participants not using CAM, 62.7% reported their prescription medications as effective or very effective compared with only 36% of CAM users (P=.0002).

Finally, only 57% of non-users and 42.5% of CAM users reported their physician assessed their use of CAM.

The authors wrote, “Our study found that CAM use is common among pediatric neurology patients. Certain disorders (headache, fatigue/pain syndromes, and sleep disorders) showed greater use of CAM. Families using CAM frequently did not self-identify as CAM users until presented with a list of CAMs, which complicates the history-taking process.”

The authors further note that physicians may have better success at identifying patients using CAM by asking specific questions or presenting examples of CAM to patients.

The study was supported by the Mayo Clinic Department of Neurology.

Reference

Kenney D, Jenkins S, Youssef P, et al. Patient use of complementary and alternative medicines in an outpatient pediatric neurology clinic. Pediatr. Neurol. 2016; doi: 10.1016/j.pediatrneurol.2015.11.003.

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