Page 100 - The clinical aspects and management of chronic migraine Judith Anne Pijpers

Chapter 5
Figure 3. Effect of maximal versus minimal behavioural intervention (for the first period of 12 weeks) on acute medication use during and after the withdrawal period.
In the first 12 weeks all patients had to withdraw from acute headache medication and were double- blinded randomized for BTX and placebo. A concealed double-blinded randomization was performed for maximal and minimal behavioral intervention in this 12 weeks period. After these 12 weeks, patients that remained CM were offered open label BTX, otherwise usual care was provided by the treating physician without further behavioral intervention of the headache nurse. A detailed explanation of maximal and minimal intervention is in the method section.
Depicted are adjusted means with standard errors derived from the linear mixed model analysis. Monthly Medication days = Monthly days with use of acute headache medication
BTX = botulinum toxin A
n.s.: non-significant; *: p <0,01
Discussion
This double-blind randomized controlled trial suggests benefit of behavioral intervention for withdrawal therapy in medication overuse headache (MOH) with reduced use of headache medication in the period after acute withdrawal. As the behavioral therapy was only provided during the withdrawal period itself (first 12 weeks), this effect gradually diminished during the long term follow up period of almost one year.
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