Trajectory of Improvement in Children and Adolescents With Chronic Migraine: Results From the Cognitive-Behavioral Therapy and Amitriptyline Trial.
J Pain
; 18(6): 637-644, 2017 06.
Article
in En
| MEDLINE
| ID: mdl-28108386
ABSTRACT
We compared headache frequency trajectories between clinical trial participants who received cognitive-behavioral therapy (CBT) and amitriptyline (CBT+A) or headache education (HE) and amitriptyline (HE+A) to determine if there was a differential time course of treatment response between the groups. One hundred thirty-five patients (age 10-17 years) diagnosed with chronic migraine participated, attending 8 one-hour one-on-one CBT or HE sessions with a trained psychologist for 8 weekly sessions, 2 sessions at weeks 12 and 16, and a post-treatment visit at week 20. Participants kept daily headache diaries and completed take-home assignments between visits. Data from daily headache diaries are presented for each day and according to 28-day periods. Trajectories of improvement indicate initial decrease in headache days began during the first month of treatment, for both groups, and continued to decrease throughout treatment. The CBT+A group had greater daily improvement than the HE+A group. A significantly greater proportion of the CBT+A group had a ≥50% reduction in headache days each month, and a significantly greater proportion of the CBT+A group had ≤4 headache days per month in months 3 through 5. Results indicate the trajectory of decrease in headache days is significantly better for patients receiving CBT+A versus HE+A. PERSPECTIVE This article presents daily information about headache frequency over a 20-week clinical trial. Youth with chronic migraine who received CBT+A improved faster than those in the control group. Findings provide clinicians with evidence-based expectations for treatment response over time and ways of monitoring treatment success. TRIAL REGISTRATION clinicaltrials.gov identifier NCT00389038.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Cognitive Behavioral Therapy
/
Analgesics, Non-Narcotic
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Amitriptyline
/
Migraine Disorders
Type of study:
Clinical_trials
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Observational_studies
/
Prognostic_studies
Limits:
Adolescent
/
Child
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Female
/
Humans
/
Male
Language:
En
Journal:
J Pain
Journal subject:
NEUROLOGIA
/
PSICOFISIOLOGIA
Year:
2017
Document type:
Article