title: The influence of multimodal behavioral treatment on the consumption of acute migraine drugs: a randomized, controlled study.
abstract: OBJECTIVE
  To characterize overall drug use in migraine in conjunction with multimodal behavioral treatment (MBT).
  
  
  METHODS
  Seventy-six adults reporting at least two monthly migraine attacks underwent a randomized, controlled, 24-week MBT intervention. Migraine drugs and symptoms were registered in an Internet-based diary.
  
  
  RESULTS
  During 4256 days of baseline registration, 859 drug doses were taken during 655 of the 856 days with migraine headache. Triptans and analgesics constituted 56.7 and 38.3% of all doses with efficacy ratios of 0.41 and 0.20, respectively. Men displayed significantly lower drug efficacy (p = 0.001), and used triptans significantly less (p < 0.001) and analgesics significantly more (p < 0.001) than women. At the end of the MBT, total drug consumption decreased by 22% (p = 0.029), corresponding to 27% fewer days with migraine headache. Drug efficacy increased during MBT from 0.30 to 0.52 (p < 0.001), mainly explained by an increased proportion of mild attacks, which also was the attack category that displayed the largest increase in drug efficacy.
  
  
  CONCLUSIONS
  Triptans were the most used and efficient drugs. MBT led to decreased and more efficient drug consumption. Men used triptans less frequently.
authors.affiliation: Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Sweden. khg@hig.se
authors.forename: Kerstin
authors.initials: K
authors.lastname: Hedborg
authors.forename: Carin
authors.initials: C
authors.lastname: Muhr
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D001521:Behavior Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000523:psychology* / Q000628:therapy*; D014363:Tryptamines / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000700:Analgesics; D014363:Tryptamines