A prospective pilot study of the effect on catecholamines of mindfulness training vs pharmacological prophylaxis in patients with chronic migraine and medication overuse headache.
Licia Grazzi, Alberto Raggi, Domenico D'Amico, Emanuela Sansone, Matilde Leonardi, Frank Andrasik, Antonina Gucciardi, Davide Guido, Giovanni D'Andrea
Cephalalgia September 13, 2018 DOI: 10.1177/0333102418801584 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Non-randomized clinic-based effectiveness study Longitudinal Pilot study Peer reviewed |
|---|---|
| Sample size | 29 |
| Population | Adults aged 18-65 with chronic migraine for at least 10 years and overuse of triptans or non-steroidal anti-inflammatory drugs for at least 5 years |
| Interventions | Pharmacological prophylaxis Mindfulness-based treatment |
| Duration | Six weekly mindfulness sessions or pharmacological prophylaxis, with 12-month follow-up |
| Measures | Daily headache diaries, plasma catecholamines (noradrenaline, epinephrine, dopamine), elusive amines |
| Topics | Meditation |
| Keywords | Humans Catecholamines Analgesics Treatment outcome Pilot projects Adult Middle aged Female Migraine disorders Headache disorders, secondary Chronic migraine Pharmacological prophylaxis |
| Key points | At 12 months, both pharmacological prophylaxis and mindfulness-based treatment were associated with significant improvement (p < .001) in headache frequency and medication intake and with increases in noradrenaline, epinephrine, and dopamine; the prophylaxis group showed reductions of 51% in headache frequency and 48.7% in medication intake and increases of 98.7%, 120.8%, and 501.9% in the three catecholamines, and mindfulness patients performed similarly. Elusive amines showed no longitudinal changes. The authors argue the similar trends support mindfulness in migraine care and suggest altered tyrosine metabolism is implicated in chronification and remission. |
Abstract
Aim: To address whether, in patients with chronic migraine and medication overuse headache, mindfulness-based treatment is associated with changes in plasma levels of catecholamines and elusive amines that are similar to those observed in patients undergoing pharmacological prophylaxis.
Methods: In this non-randomized, clinic-based effectiveness study, patients aged 18-65, with a history of chronic migraine ≥ 10 years and overuse of triptans or non-steroidal anti-inflammatory drugs ≥ 5 years, were enrolled. Upon completion of a structured withdrawal program, patients received either pharmacological prophylaxis or six weekly sessions of mindfulness-based treatment and were followed for 12 months. Daily headache diaries were used to record headache frequency and medication intake; catecholamines (noradrenaline, epinephrine and dopamine) and levels of elusive amines were assayed from poor platelet plasma.
Results: Complete follow-up data were available for 15 patients in the pharmacological prophylaxis-group (14 females, average age 44.1) and 14 in the mindfulness treatment-group (all females, average age 46.4), and all variables were comparable between groups at baseline. At 12 months, significant improvement ( p < .001) was found in the pharmacological prophylaxis group for headache frequency and medication intake (by 51% and 48.7%, respectively), noradrenaline, epinephrine and dopamine (by 98.7%, 120.8% and 501.9%, respectively); patients in the mindfulness treatment-group performed similarly. For elusive amines, no longitudinal changes were found.
Conclusions: The similar improvement trends observed in the two groups of patients further support the utility of mindfulness-based treatment in migraine care, and reinforce the hypothesis that alteration and normalization of tyrosine metabolism are implicated in migraine chronification and in remission of chronic migraine.
Comparable studies
Other non-randomized and open-label trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients Early-stage breast and prostate cancer patients | 2003 | Pre-post intervention study | n = 59 |
| Exploring self‐compassion and empathy in the context of mindfulness‐based stress reduction (MBSR) Community sample | 2010 | Pre-post intervention study | |
| Mindfulness-Based Stress Reduction Lowers Psychological Distress In Medical Students Second-year medical students | 2003 | Prospective nonrandomized cohort-controlled study | n = 302 |
| Intensive meditation training, immune cell telomerase activity, and psychological mediators. Retreat participants and matched controls | 2011 | Controlled trial with wait-list control group | n = 60 |
| The Effectiveness of Mindfulness Training for Children with ADHD and Mindful Parenting for their Parents Children aged 8-12 with ADHD and their parents | 2011 | Within-group waitlist controlled trial | n = 22 |
Citations in the library
Cited by 5
- Mindfulness in migraine: A narrative review Expert Review of Neurotherapeutics January 14, 2020
- Meditation Practice, Mindfulness, and Pain-Related Outcomes in Mindfulness-Based Treatment for Episodic Migraine. Mindfulness April 1, 2023
- Neurotransmitter-related functional connectivity changes in serotonin and dopamine systems after mindfulness in medication overuse headache. Cephalalgia June 1, 2025
- Mindfulness and other behavioral approaches. Neurological Sciences September 2022
- Meditative and Mindfulness-Focused Interventions in Neurology: Principles, Science, and Patient Selection. Seminars in neurology April 1, 2022
Cites 7
- Mindfulness and pharmacological prophylaxis after withdrawal from medication overuse in patients with Chronic Migraine: an effectiveness trial with a one-year follow-up. The Journal of Headache and Pain December 2017
- Mindfulness and pharmacological prophylaxis have comparable effect on biomarkers of inflammation and clinical indexes in chronic migraine with medication overuse: results at 12 months after withdrawal. Neurological Sciences May 2017
- Mindfulness and headache: A "new" old treatment, with new findings. Cephalalgia October 2016
- Brain mechanisms supporting the modulation of pain by mindfulness meditation. Journal of Neuroscience April 6, 2011
- A non-elaborative mental stance and decoupling of executive and pain-related cortices predicts low pain sensitivity in Zen meditators. Pain 2011
and 2 more in the library