Mindfulness and pharmacological prophylaxis after withdrawal from medication overuse in patients with Chronic Migraine: an effectiveness trial with a one-year follow-up.
Licia Grazzi, Emanuela Sansone, Alberto Raggi, Domenico D'Amico, Andrea De Giorgio, Matilde Leonardi, Laura De Torres, Francisco Salgado-García, Frank Andrasik
The Journal of Headache and Pain December 2017 DOI: 10.1186/s10194-017-0728-z (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Longitudinal Peer reviewed |
|---|---|
| Sample size | 44 |
| Population | Patients with chronic migraine and medication overuse (ICHD-3Beta codes 1.3 and 8.2) who completed an inpatient withdrawal program |
| Interventions | Mindfulness-based training Prophylactic Medications |
| Duration | 6 weekly mindfulness sessions; follow-up at 3, 6, and 12 months after withdrawal |
| Measures | Headache diaries, Headache Impact Test (HIT-6), Migraine Disability Assessment (MIDAS), State-Trait Anxiety Inventory (STAI Y1-Y2), Beck Depression Inventory (BDI) |
| Topics | Meditation |
| Keywords | Chronic migraine Medication overuse Pharmacological prophylaxis |
| Key findings | Patients receiving mindfulness training without prophylactic medication showed improvements in headache frequency, medication use, disability, and depression that were substantially similar to those receiving prophylactic medication over 12 months. Both groups had significant and equivalent rates of 50% or greater headache reduction, and most patients in each group no longer met criteria for chronic migraine. |
Abstract
Chronic Migraine (CM) is a disabling condition, worsened when associated with Medication Overuse (MO). Mindfulness is an emerging technique, effective in different pain conditions, but it has yet to be explored for CM-MO. We report the results of a study assessing a one-year course of patients' status, with the hypothesis that the effectiveness of a mindfulness-based approach would be similar to that of conventional prophylactic treatments. Patients with CM-MO (code 1.3 and 8.2 of the International Classification of Headache Disorders-3Beta) completed a withdrawal program in a day hospital setting. After withdrawal, patients were either treated with Prophylactic Medications (Med-Group), or participated in a Mindfulness-based Training (MT-Group). MT consisted of 6 weekly sessions of guided mindfulness, with patients invited to practice 7-10 min per day. Headache diaries, the headache impact test (HIT-6), the migraine disability assessment (MIDAS), state and trait anxiety (STAI Y1-Y2), and the Beck Depression Inventory (BDI) were administered before withdrawal and at each follow-up (3, 6, 12 after withdrawal) to patients from both groups. Outcome variables were analyzed in separate two-way mixed ANOVAs (Group: Mindfulness vs. Pharmacology x Time: Baseline, 3-, 6-, vs. 12-month follow-up). A total of 44 patients participated in the study, with the average age being 44.5, average headache frequency/month was 20.5, and average monthly medication intake was 18.4 pills. Data revealed a similar improvement over time in both groups for Headache Frequency (approximately 6-8 days reduction), use of Medication (approximately 7 intakes reduction), MIDAS, HIT-6 (but only for the MED-Group), and BDI; no changes on state and trait anxiety were found. Both groups revealed significant and equivalent improvement with respect to what has become a classical endpoint in this area of research, i.e. 50% or more reduction of headaches compared to baseline, and the majority of patients in each condition no longer satisfied current criteria for CM. Taken as a whole, our results suggest that the longitudinal course of patients in the MT-Group, that were not prescribed medical prophylaxis, was substantially similar to that of patients who were administered medical prophylaxis.
Comparable studies
Other observational and cohort studies on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Using Self-Report Assessment Methods to Explore Facets of Mindfulness Undergraduate students | 2006 | Observational cohort | |
| Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders Patients with generalized anxiety disorder or panic disorder with or without agoraphobia | 1992 | Observational cohort | n = 22 |
| Meditation experience is associated with increased cortical thickness Participants with extensive Insight meditation experience and matched controls | 2005 | Observational cohort | n = 20 |
| Meditation experience is associated with differences in default mode network activity and connectivity Experienced meditators and matched meditation-naive controls | 2011 | Observational cohort | |
| Long-term meditators self-induce high-amplitude gamma synchrony during mental practice Long-term Buddhist practitioners and controls | 2004 | Observational cohort |
Citations in the library
Cited by 9
- Mindfulness in migraine: A narrative review Expert Review of Neurotherapeutics January 14, 2020
- Longitudinal neurofunctional changes in medication overuse headache patients after mindfulness practice in a randomized controlled trial (the MIND-CM study). The Journal of Headache and Pain June 11, 2024
- Intensive Mindfulness Meditation Reduces Frequency and Burden of Migraine: An Unblinded Single-Arm Trial. Mindfulness February 1, 2023
- A meta-analytic review of acceptance-based interventions for migraine. Headache: The Journal of Head and Face Pain August 27, 2023
- Efficacy of mindfulness added to treatment as usual in patients with chronic migraine and medication overuse headache: a phase-III single-blind randomized-controlled trial (the MIND-CM study). The Journal of Headache and Pain July 14, 2023
and 4 more in the library
Cites 14
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- Mindfulness meditation for the treatment of chronic low back pain in older adults: A randomized controlled pilot study ☆ Pain June 4, 2007
- Mindfulness-based cognitive therapy for recurrent depression: A translational research study with 2-year follow-up Australian & New Zealand Journal of Psychiatry March 4, 2014
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- Effects of mindfulness-based stress reduction on perceived stress and psychological health in patients with tension headache. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences November 2015
and 9 more in the library