Mindfulness versus Pharmacological Preventative Treatment for Chronic Migraine (CM) with Medication Overuse (MO): Preliminary Findings (P2.204)

Objective: To report preliminary findings from an on-going trial exploring the feasibility and utility of mindfulness as a primary treatment for this condition. Background: Chronic migraine arises from a complex mixture of interconnected biological, psychological and social factors. CM is a disabling condition that is worsened when associated with medication overuse. Mindfulness is emerging as a helpful treatment for pain, but it has yet to be explored fully for CM with MO. Methods: Forty-four patients, diagnosed as CM with MO (IHS-3 beta 2013 criteria), are presently enrolled. After baseline, all patients complete a standardized medication withdrawal in a day hospital setting. Patients are then assigned to 1 of 2 conditions: Prophylactic Medication Alone (Med) or Mindfulness Training (MT), which additionally included magnesium and exercise. MT was administered during 6 weekly sessions, each consisting of 30 minutes of guided mindfulness, with patients instructed to engage in 7 minutes of practice each day at home. Patients were instructed to keep their eyes closed, focus attention on their breathing and present events in a “non-judgmental moment-to-moment awareness”. All patients are providing followup data before and 3, 6, 12 months after withdrawal, using daily pain diaries and measures of disability (MIDAS), quality of life (HIT-6), state and trait anxiety (STAI X1-X2), and depression (BDI-II). Results: Twenty patients have now reached the 6-month assessment for each condition. Both groups have reported significant decreases in key headache parameters and MIDAS values (but no changes for other measures): 45[percnt] improvement in HA Days/Month for each; and 42 vs. 53[percnt] improvement in Medication Consumption and 52 vs. 39[percnt] improvement in MIDAS Scores for MED and MT, respectively. Conclusions: Our results provide preliminary evidence of equivalent effects for MED and MT. Data collection is continuing to assess whether these encouraging findings endure over more extended time periods. Disclosure: Dr. Grazzi has nothing to disclose. Dr. Sansone has nothing to disclose. Dr. Raggi has nothing to disclose. Dr. Leonardi has nothing to disclose. Dr. D9Amico has nothing to disclose. Dr. Andrasik has nothing to disclose.