Tranquilizers and Mood Elevators in the Treatment of Migraine: An Analysis of the Migraine Foundation Questionnaire

Current treatment of migraine either abortive or prophylactic is often unsatisfactory. Prophylactic treatment of severe migraine may reduce attack frequency, and current therapy centers on beta-blockers, serotonin (5-HT) reuptake blockers and 5-HT2 receptor antagonists. The author compared the efficacy and safety of amitriptyline and fluvoxamine among migraine patients (24F, 8M vs. 23F, 9M) in a double blind study. The efficacy of amitriptyline has already been established by earlier clinical studies. The other investigated drug, fluvoxamine, has a more selective 5-HT reuptake blocking property than amitriptyline. In this study, amitriptyline significantly reduced the number of headache attacks, but it caused severe drowsiness in many migraineurs. The fluvoxamine also favorably influenced on the number of headache attacks and caused only slight side effects. These findings suggest, that fluvoxamine may be an alternative drug in migraine prophylaxis, however, further studies should be performed with more subjects.

Section: Introductionmentioning

confidence: 99%

A Comparative Study of Amitriptyline and Fluvoxamine in Migraine Prophylaxis

Bánk

1994

“…Migraine patients most often identified stress-related variables as responsible for the onset of their migraine headaches. 1 Bakal (1975) reviewed the literature on precipitants of headaches and similarly concludes that headaches (including migraine headaches) are a physiological reaction of stressful stimulation. Some 30 years ago, Wolff (1948) emphasized the role of stress in bringing on migraine headaches and felt that a major point of treatment was "... to help the individual understand the basis of his tension, the factors in his life that aggravate it, and to aid him in resolving his conflicts."…”

Section: Introductionmentioning

confidence: 99%

“…Even though such evidence for the efficacy of stress-related treatment exists, only a small percentage of migraine headache sufferers are ever exposed to this type of treatment regimen, whereas medication is frequently employed. 1,15 There are several reasons that could account for the relative prevalence of medication and the paucity of stress-related treatment. First, the availability of stress-related migraine treatment programs would be limited to larger metropolitan areas and thus would not be available to individuals who live in suburban or rural settings.…”

Section: Introductionmentioning

confidence: 99%

Self‐help Treatment for Migraine Headaches: A Controlled Outcome Study

Kohlenberg

Cahn

1981

SYNOPSIS A self‐help approach for the control of migraine headaches was evaluated. Self‐help refers to a self‐directed effort, without therapist contact aimed at reducing the symptoms of migraine. The experimental plan involved giving migraine headache patients one of two experimental books and then evaluating the effect. Subjects were recruited through newspaper announcements and were required to have had at least two vascular headaches per month. During the first six weeks of the study, the baseline period, all subjects recorded headache frequency, intensity and duration. Subjects were then matched for headache frequency and then randomly assigned to receive either the treatment or control book. The treatment book contained instructions for thermal biofeedback, relaxation and cognitive behavior therapy. A liquid crystal device for measuring fingertip temperature was also included. Instructions in the treatment book were written such that a self‐help, no‐therapist treatment could be followed by the subject. The control book was a popularly available paperback in which a series of case studies on headache treatment and diagnosis were discussed. It was selected because it was easy to read and contained information about headaches but did not necessarily direct the reader to start a self‐help program. Data was obtained for 51 subjects who completed a three‐ and six‐month followup data collection period (treatment N = 22, control N = 29). There was a 62% decrease in headache frequency at six months for subjects who received the treatment book and a 14% drop for those who received the control book. Corresponding findings were also obtained for duration and pain levels of the headache as well as for prescribed medication use. Although the results indicated that this type of self‐help treatment could be effective for many migraine patients, limitations and cautions in interpretation of these results were discussed.

“…(Headache 29:352-357, 1989) Numerous studies have found emotional reactivity to be a precipitating factor for migraine headaches. [1][2][3][4][5][6][7][8][9] In cognitive-behavioral therapy the aim of treatment is to help people learn to modulate those maladaptive attitudes, appraisals, expectations and behaviors which contribute to anxiety and distress and which may, therefore, play a role in the precipitation and exacerbation of headaches. Several studies have demonstrated the efficacy of this approach for the treatment of migraine headaches.…”

mentioning

confidence: 99%

Cognitive‐Behavioral Therapy for Migraine Headaches: A Minimal‐Therapist‐Contact Approach Versus a Clinic‐Based Approach

Richardson

McGrath

1989

The efficacy of a clinic-based cognitive-behavioral program for the treatment of common migraine was compared to the same approach using a minimal-therapist-contact format by means of a randomized controlled trial. Forty-eight subjects between 18 and 50 years of age completed the program. Following four weeks of recording headache activity, subjects were randomly assigned to a waiting list control condition or to one of the two treatment conditions. Treatment was followed by four weeks of recording of headache activity immediately posttreatment and again six months later. Multivariate analysis of variance indicated that there was a significant reduction in headache frequency, duration and peak intensity following treatment for both treated groups. These reductions were maintained at six months follow-up. Treatment for the minimal-contact group was significantly more cost-effective than for the clinic group.