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SHTAC publishes a systematic review on cognitive behavioural therapy for the management of headaches and migraines

Published: 29 April 2015

The systematic review of the effectiveness of cognitive behavioural therapy for the management of headaches and migraines shows mixed findings.

Headaches are one of the most common neurological problems in the UK. Many headaches can be self-managed with analgesics, however their efficacy tends to decrease with frequent use and overuse can lead to more headaches. Psychological comorbidity such as fatigue and anxiety are common. While headaches and migraines are generally not life threatening, they are a cause of personal and social burden with a substantial economic impact. Cognitive behavioural therapy (CBT) may offer a long-term solution to relieve suffering, with the potential to eliminate some of the side-effects and costs associated with medication.

The review, published in the British Journal of Pain, included 10 randomised controlled trials (RCTs) evaluating a variety of comparators including relaxation, medication, and biofeedback. CBT was more effective in improving headache- or migraine-related outcomes compared to relaxation only or antidepressant medication. In some studies, however, CBT did not appear to be more effective than alternative treatments. Due to methodological inadequacies in the evidence base it difficult to draw any meaningful conclusions about overall effectiveness.

An RCT of CBT for headaches/migraine in primary care may be beneficial, with CBT based on step-wise treatment to enable the identification of the specific component(s) that may be responsible in reducing any headache/ migraines symptoms.

For more information on SHTAC’s research into brain and nervous system disorders please visit our Research page.

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