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CBT Can Relieve Chronic Migraines

Update Date: Dec 26, 2013 02:11 PM EST

People who suffer form chronic migraines deal with pain frequently. Migraine can greatly interfere with daily activities. According to the background information provided by the researchers of a new study, over two percent of the adult population suffers from chronic migraine and around 1.75 percent of the adolescent population does as well. Despite the prevalence of migraines in young children, there is no FDA (U.S. Food and Drug Administration) approved intervention treatment for this age group. In the new study, researchers found that cognitive behavioral therapy (CBT) could be an effective form of treatment.

For this study, the team headed by Scott W. Power, Ph.D. from the Cincinnati Children's Hospital Medical Center, recruited 135 participants between the ages of 10 and 17. 79 percent of the adolescents were females and all of them suffered from chronic migraine. Chronic migraine was defined as having 15 or more headache days within a month. The participants also had a PedMIDAS (Pediatric Migraine Disability Score) score of 20 or above. A PedMIDAS score from 0-10 is considered none, a score from 11-30 is mild, a score from 31-50 is moderate and any thing above 50 is severe.

Of the 135 adolescents, 129 completed 20 weeks of follow up and 124 of the participants lasted through the 12-month follow up. 64 of the participants were assigned to the CBT group and the remaining 71 participants enrolled in the headache education group. There was a total of 10 sessions and the groups had equal time and therapist attention. All participants were given the prescription drug, amitriptyline. Follow ups occurred at weeks three, six, nine, and 12 months.

At the start of the study, the average number of headache days was 21 out of 28 days. The average PedMIDAS score was 68 points. Between the pretreatment days and the post-treatment days, the researchers found that people in the CBT group had a reduction of 11.5 headache days. The education group had a reduction of 6.8 headache days. At the 12-month follow up, 86 percent of the CBT group and 69 percent of the education group experienced a 50 percent greater reduction in headache days. The PedMIDAS scores reduced to below 20 for 88 percent of the people in the CBT group and for 76 percent of the people in the education group.

"Now that there is strong evidence for CBT in headache management, it should be routinely offered [to younger people] as a first-line treatment for chronic migraine along with medications and not only as an add-on if medications are not found to be sufficiently effective. Also, CBT should be made more accessible to patients by inclusion as a covered service by health insurance as well as testing of alternate formats of delivery, such as using online or mobile formats, which can be offered as an option if in-person visits are a barrier," the authors wrote according to Medical Xpress.

The study was published in the Journal of the American Medical Association.

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