Interval Therapy of Migraine: Long‐term Results

Abstract

SYNOPSIS Recrudescence of migraine headaches some time after the initiation of drug prophylaxis and the responsiveness of many patients to one or more vasoactive agents but not others are factors that have not hitherto been incorporated into a systematic appraisal of the putative long‐term benefits of migraine therapy. In this study, followup information was obtained upon 146 treated migraineurs who were initially evaluated within the last 9 years and were drawn randomly from coded files; the major component of their treatment was the sequential use of the following drugs: propranolol, amitriptyline, ergonovine, methysergide, ergotamine, phenelzine, papaverine and cyproheptadine. Data was also collected upon 85 age‐matched patients who chose a variety of treatment modes other than drugs in an attempt to lessen headache problems that were comparable to the drug‐treated group. The mean followup period for both groups was 35 months. Of the drug‐treated patients, 55% evidenced substantial improvement of at least one year‘s duration compared to 26% of the control group (p<.01); improvement of at least 2 years’ duration was apparent among 31% of the drug‐treated patients whereas 12% of the controls did as well (p<.01). Prophylactic migraine therapy proffers substantial long‐term benefits to some patients.