ACT for Migraine: Effect of Acceptance and Commitment Therapy (ACT) for High Frequency Episodic Migraine without Aura: A phase-II, multicentric, randomized, open-label study (P2.10-004)

Objective: To assess the feasibility of a novel ACT model for patients with HFEM and its effectiveness respect to a standard treatment. Background: Patients with High Frequency Episodic Migraine without Aura (HFEM) are particularly exposed to the risk of chronification and medication overuse. The “cephalalgiophobia”, is a common trait in these patients and induces anxiety, depression and increased medication intake and headache frequency. These patients need a multidisciplinary approach to manage their problem before chronification. Recently, non pharmacological approaches as Mindfulness, Acceptance Commitment Therapy (ACT) , showed encouraging results for pain conditions & migraine, comparable to pharmacological prophylaxis at long-term. The goal is the psychological flexibility by cultivating positive psychological capacities which can improve mental & physical states, disability, and impact in pain conditions. Design/Methods: Twenty four Patients with HFEM were included and randomized for the study (9/14 episodes per month). Two treatment conditions. 1) TaU: pharmacological prophylaxis (topiramate, amitriptyline, beta blocker, Ca channel blockers) (11 patients); 2) TaU + ACT (13 patients). The ACT consisted of six weekly 90 minutes sessions and two booster sessions, one every 15 days; small groups of patients. Sessions involve: psycho-education, discussions, experiential exercises and home assignments Results: Results showed decrease in days of headache /month in the ACT-group (10+2.0 vs 6.5+3.5 at 3 months), not in the TaU-group (9.27+3.43 vs 11.5+4.71) , and of medication intake /month in the ACT-group ( 9.4+2.75 vs 5.75+3.3) not in the TaU-group (9.9+3.6 vs 10.5 +5.8). Patients of the ACT group were actively involved and participated regularly at the sessions. Conclusions: Although preliminary, results show that ACT seems suitable for this category of patients. An integrated and flexible treatment combining different approaches may be more effective than drugs alone to alleviate pain, to reinforce clinical improvement. Disclosure: Dr. Grazzi has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Allergan, Inc. and ElectroCore, LLC. Dr. Bernstein has nothing to disclose. Dr. Raggi has nothing to disclose. Dr. Sansone has nothing to disclose. Dr. Grignani has nothing to disclose. Dr. Searl has nothing to disclose. Dr. Rizzoli has nothing to disclose.