Therapy for Treating Children's Migraines

Cognitive behavioral therapy reduced days with headaches in children with chronic migraines

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Children who have frequent migraines sometimes take medication to ease symptoms. New research shows that therapy may also be an effective treatment.

Researchers tested behavioral therapy and medication against headache education and medication for youth with chronic migraines.

The group who had weekly therapy reported more days without headaches and improved disability symptoms.

The authors of this study suggested that therapy, which focused on coping with pain, could successfully treat migraines in children.

"Talk to your child's pediatrician about therapy for migraines."

Scott Powers, PhD, of the Division of Behavioral Medicine and Clinical Psychology in Cincinnatti Children's Hospital Medical Center, led this study.

Children who have migraines, or very intense and chronic headaches, may experience difficulty with school and social activities.

This study tested cognitive behavioral therapy, or CBT, as a treatment for chronic migraines in children.

CBT focuses on helping people become aware of and change harmful thinking in order to change harmful behaviors.

Dr. Powers and colleagues recruited 135 participants between the ages of 10 and 17 years old who had at least 15 or more headaches per month and severe disability due to migraines.

The participants were mostly male and reported an average of 21 days with headaches of the 28 days before the study began.

The participants went through an assessment process that included a medical and psychosocial screening. Each of the participants had also completed a 28-day headache diary prior to the beginning of the study.

The participants were assigned to a therapy group or an educational group.

The therapy group received eight weekly, one-hour CBT sessions in addition to amitriptyline (brand name Elavil, Endep, Levate and others), a medication commonly used to treat migraines and depression.

The control group received eight weekly, one-hour educational sessions on headache-related topics, as well as the amitriptyline.

Additional therapy and educational sessions occurred at weeks 12 and 16, then at the three, six and 12-month follow-up visits.

After 20 weeks, the researchers determined how many days without headaches each participant had, as well as their migraine disability scores.

The researchers found that, on average, the participants in the therapy group had 11.5 fewer headaches than at baseline, while the educational group had an average of 6.8 fewer days without headaches.

Additionally, 66 percent of the therapy group had a 50 percent or greater reduction in days with headaches. Only 36 percent of the education group achieved the same result.

Participants in the therapy group also experienced a significantly larger decrease in their migraine disability scores.

Both treatments were well tolerated by the participants.

The authors of this study concluded that youth with chronic migraines may benefit from the use of cognitive behavioral therapy in addition to medications like amitriptyline.

The study was published in JAMA on December 24.

The research was funded by the National Institute of Neurological Disorders and Stroke, the National Center for Research Resources and the National Center for Advancing Translational Sciences. The authors of the study reported no conflicts of interest.

Review Date: 
December 23, 2013
Last Updated:
February 10, 2014