A recent study found cognitive behavioral therapy (CBT) could work to reduce the effects of chronic migraines in children and adolescents.
"In adults, more than [two] percent of the population has chronic migraine and in children and adolescents the prevalence is up to 1.75 percent. In pediatric patients who seek care in headache specialty clinics, up to 69 percent have chronic migraine; however, there are no interventions approved by the U.S. Food and Drug Administration (FDA) for the treatment of chronic migraine in young persons. As a result, current clinical practice is not evidence-based and quite variable," the article stated, according to a JAMA Network Journals news release.
The researchers looked at a group of 135 participants that were 75 percent female, between the ages of 10 and 17, and had been diagnosed with chronic migraines.
At the beginning of the trial most participants reported between 21 and 28 headache days and a Pediatric Migraine Disability Assessment Score of about 68 (above 50 indicates severe disability).
The team found the patients treated with CBT saw an average decrease of 11.5 headache days; those who received only headache education only had a reduction of 6.8 days.
"Now that there is strong evidence for CBT in headache management, it should be routinely offered [to younger people] as a first-line treatment for chronic migraine along with medications and not only as an add-on if medications are not found to be sufficiently effective. Also, CBT should be made more accessible to patients by inclusion as a covered service by health insurance as well as testing of alternate formats of delivery, such as using online or mobile formats, which can be offered as an option if in-person visits are a barrier," the authors wrote according to the news release.
The researchers worry "system barriers" may stand in the way of behavioral therapy being implemented as a primary migraine treatment in adolescents.
"Ideally with the efforts of the health care community and other relevant stakeholders, the suggestion by Powers et al to consider CBT along with medication as a first-line treatment for chronic migraine in children will be implemented into practice well before the typical translation gap. Additional studies are warranted, however, to identify methods of preventing chronic migraine development and to determine the medications and combination therapies that further maximize improvements in health and quality of life outcomes for children and adolescents with chronic migraine," Mark Connelly, Ph.D., of Children's Mercy Hospitals and Clinics, Kansas City wrote in an accompanying editorial, the news release reported.
