Recurrent Vascular Headache: Home-Based Behavioral Treatment Versus Abortive Pharmacological Treatment

This study compared the effectiveness of a home-based behavioral intervention with an abortive pharmacological intervention for treating recurrent migraine and mixed migraine and tension headaches. Relaxation training and thermal-biofeedback training were provided to 19 patients in a home-based treatment format that required minimal therapist contact, whereas 18 patients received ergotamine tartrate accompanied by a compliance-training intervention to assist them in making optimal use of the medication. The two treatments yielded similar reductions in headache activity ( M s = 52% and 41%, respectively), psychosomatic symptoms, and daily life stress. However, the two treatments differed in (a) the timing of improvements, (b) their impact on analgesic medication use, and (c) the variables that predicted treatment response. The results highlight the role that psychological variables may play in pharmacological treatment and provide additional evidence that behavioral treatment can be effectively administered in a home-based treatment format.