(HealthDay News) – Cognitive behavioral therapy (CBT) is superior to headache education, when combined with amitriptyline, for the treatment of chronic migraine in children and adolescents, according to research published in the Dec. 25 issue of the Journal of the American Medical Association.

Scott W. Powers, PhD, of the University of Cincinnati, and colleagues randomly assigned 135 youth (79% female) aged 10–17 years, who were diagnosed with chronic migraine, to either CBT plus amitriptyline (64 patients) or headache education plus amitriptyline (71 patients).

The researchers found that, at 20 weeks, the reductions in the number of days with headache and migraine disability score were significantly greater in the CBT group (11.5 days; 52.7 points) than in the headache education group (6.8 days; 38.6 points). At 12 months, 86% of the CBT group had a 50% or greater reduction in number of headache days, compared with 69% in the headache education group.

“The trial quality lends confidence in asserting that superior outcomes in pain and disability are likely to be observed with cognitive behavioral therapy (versus only extra headache education) when used in conjunction with a prophylactic medication for pediatric chronic migraine,” writes the author of an accompanying editorial.

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