My 11 yr old could not tolerate Amitryptiline or Topomax. She was recently switched to Peiactin for migraines, starting 3-4 days ago at 4mg total per day. However, there was a MAJOR rage fit today (out of the blue) with elements of depression and, though I don't think it's the medication, I am still concerned. I do think it is starting to reduce her migraines and improve her appetite. I felt more at ease starting this than the other two medications, but now I am starting to have doubts. And I am supposed to increase the dose soon which is another worry.