Mean age of onset of cyclical vomiting syndrome is about 5 years, and attacks typically last about 3.5 days. Children may have comorbid headaches or migraine, she added.
There have been no randomized, controlled trials of treatments, but limited data support the off-label use of amitriptyline, propranolol, coenzyme Q10, L-carnitine, cyproheptadine, flunarizine, and valproate as preventives, and the off-label use of sumatriptan (especially subcutaneously) and ondansetron as acute treatments. Some data also support the off-label use of the neurokinin-1 receptor antagonist aprepitant as an acute and preventive treatment, she said.
Dr. Gelfand reported no relevant financial conflicts.