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Preventive Medications and Behavior Management Are Better Together

The first controlled study to assess the combination of preventive drugs and behavioral techniques for hard-to-treat migraines found that using the techniques together leads to better outcomes. The study enrolled 232 people with frequent headaches that weren’t controlled by acute medicines. They were randomly assigned to receive preventive medications (a beta blocker), behavioral management, both or neither. After 16 months of follow up, the combined approach offered significant improvement in number of attacks, headache days and quality of life, compared to modest improvement in those who used only one of the techniques.

The behavioral management program included learning to identify migraine triggers and warning signs, relaxation skills and muscle stretching exercises, cognitive-behavioral stress management and thermal biofeedback training. Participants were also given a written migraine management plan.

“Relentless, individualized fine-tuning of the acute therapy improves outcomes,” said researcher Gary Cordingley, associate professor of neurology at the Ohio University College of Osteopathic Medicine. “Supplemental treatment combining preventive medication and behavioral management raises that improvement to a still-higher level.”

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