Abstract Details

Title 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

Topic Headache

Presentation(s) P2 - Poster Session 2 (5:30 PM-6:30 PM)

Poster/Presentation
Number 13-004

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.

Authors/Disclosures
Licia Grazzi, MD (Neurological Institute C Besta) PRESENTER	Dr. Grazzi has received personal compensation in the range of $0-$499 for serving as a Consultant for EliLilly. Dr. Grazzi has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for allergan-abbvie.
Carolyn Bernstein, MD	Dr. Bernstein has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Ogletree. Dr. Bernstein has or had stock in Percept. The institution of Dr. Bernstein has received research support from Crimson Lion foundation. The institution of Dr. Bernstein has received research support from teva. Dr. Bernstein has received publishing royalties from a publication relating to health care.
	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Paul B. Rizzoli, MD, FAAN (BW/F Neurology)	Dr. Rizzoli has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Axsome. Dr. Rizzoli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Theranica. Dr. Rizzoli has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Axsome. Dr. Rizzoli has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Headache Cooperative of New England. Dr. Rizzoli has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Harvard Health Publishing. The institution of Dr. Rizzoli has received research support from Abbvie. Dr. Rizzoli has received publishing royalties from a publication relating to health care.

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