Mindfulness and pharmacological prophylaxis after withdrawal from medication overuse in patients with Chronic Migraine: an effectiveness trial with a one-year follow-up.

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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.

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Most cited references 52

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The clinical use of mindfulness meditation for the self-regulation of chronic pain.

Jon Kabat-Zinn, Leslie Lipworth, Robert G. Burney (1985)

Ninety chronic pain patients were trained in mindfulness meditation in a 10-week Stress Reduction and Relaxation Program. Statistically significant reductions were observed in measures of present-moment pain, negative body image, inhibition of activity by pain, symptoms, mood disturbance, and psychological symptomatology, including anxiety and depression. Pain-related drug utilization decreased and activity levels and feelings of self-esteem increased. Improvement appeared to be independent of gender, source of referral, and type of pain. A comparison group of pain patients did not show significant improvement on these measures after traditional treatment protocols. At follow-up, the improvements observed during the meditation training were maintained up to 15 months post-meditation training for all measures except present-moment pain. The majority of subjects reported continued high compliance with the meditation practice as part of their daily lives. The relationship of mindfulness meditation to other psychological methods for chronic pain control is discussed.

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A six-item short-form survey for measuring headache impact: the HIT-6.

M Kosinski, M S Bayliss, J. Bjorner … (2003)

Migraine and other severe headaches can cause suffering and reduce functioning and productivity. Patients are the best source of information about such impact. To develop a new short form (HIT-6) for assessing the impact of headaches that has broad content coverage but is brief as well as reliable and valid enough to use in screening and monitoring patients in clinical research and practice. HIT-6 items were selected from an existing item pool of 54 items and from 35 items suggested by clinicians. Items were selected and modified based on content validity, item response theory (IRT) information functions, item internal consistency, distributions of scores, clinical validity, and linguistic analyses. The HIT-6 was evaluated in an Internet-based survey of headache sufferers (n = 1103) who were members of America Online (AOL). After 14 days, 540 participated in a follow-up survey. HIT-6 covers six content categories represented in widely used surveys of headache impact. Internal consistency, alternate forms, and test-retest reliability estimates of HIT-6 were 0.89, 0.90, and 0.80, respectively. Individual patient score confidence intervals (95%) of app. +/-5 were observed for 88% of all respondents. In tests of validity in discriminating across diagnostic and headache severity groups, relative validity (RV) coefficients of 0.82 and 1.00 were observed for HIT-6, in comparison with the Total Score. Patient-level classifications based in HIT-6 were accurate 88.7% of the time at the recommended cut-off score for a probability of migraine diagnosis. HIT-6 was responsive to self-reported changes in headache impact. The IRT model estimated for a 'pool' of items from widely used measures of headache impact was useful in constructing an efficient, reliable, and valid 'static' short form (HIT-6) for use in screening and monitoring patient outcomes.

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Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial.

Alice Weaver, Alison Evans, Felix Gradinger … (2015)

Individuals with a history of recurrent depression have a high risk of repeated depressive relapse or recurrence. Maintenance antidepressants for at least 2 years is the current recommended treatment, but many individuals are interested in alternatives to medication. Mindfulness-based cognitive therapy (MBCT) has been shown to reduce risk of relapse or recurrence compared with usual care, but has not yet been compared with maintenance antidepressant treatment in a definitive trial. We aimed to see whether MBCT with support to taper or discontinue antidepressant treatment (MBCT-TS) was superior to maintenance antidepressants for prevention of depressive relapse or recurrence over 24 months.

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Author and article information

Journal

Journal ID (iso-abbrev): J Headache Pain

Title: The journal of headache and pain

Publisher: Springer Nature

ISSN (Electronic): 1129-2377

ISSN (Print): 1129-2369

Publication date (Electronic): Dec 2017

Volume: 18

Issue: 1

Affiliations

[1 ] Neurological Institute "C. Besta" IRCCS Foundation, Headache and Neuroalgology Unit, Via Celoria 11, 20133, Milan, Italy. licia.grazzi@istituto-besta.it.

[2 ] Neurological Institute "C. Besta" IRCCS Foundation, Neurology, Public Health and Disability Unit, Milan, Italy.

[3 ] Neurological Institute "C. Besta" IRCCS Foundation, Headache and Neuroalgology Unit, Via Celoria 11, 20133, Milan, Italy.

[4 ] eCampus University, Faculty of Psychology, Novedrate, Italy.

[5 ] Department of Psychology, Univeristy of Memphis, Memphis, TN, USA.

Article

Publisher Item ID: 10.1186/s10194-017-0728-z

DOI: 10.1186/s10194-017-0728-z

PMC ID: 5292107

PubMed ID: 28161874

SO-VID: 3a32c603-e098-4774-81df-ad87358b177b

History

Keywords: Chronic migraine,Medication overuse,Mindfulness,Pharmacological prophylaxis

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Keywords: Chronic migraine, Medication overuse, Mindfulness, Pharmacological prophylaxis

Mindfulness and pharmacological prophylaxis after withdrawal from medication overuse in patients with Chronic Migraine: an effectiveness trial with a one-year follow-up.

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Most cited references 52

The clinical use of mindfulness meditation for the self-regulation of chronic pain.

A six-item short-form survey for measuring headache impact: the HIT-6.

Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial.

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