Comparing and contrasting standard pharmaco-therapeutic treatments versus alternative and complementary treatments for migraine headaches

A project presented to the Department of Physician Assistant of Wichita State University in partial fulfillment of the requirements for the degree of Master of Physician Assistant.Migraine headaches affect an estimated 28 million Americans, cost the nation an estimated $14 billion annually, and are very difficult to treat effectively. The exact etiology of migraine headaches is still unknown, although many theories exist; this makes finding an effective treatment even more challenging. Methodology: This literature review sought to compare and contrast the effectiveness of standard pharmaco-therapeutic treatments versus alternative, complementary treatments for the treatment of migraine headache. Searches were performed in peer-reviewed journals dating from 1980. Search terms included migraine, drug therapy, diet therapy, prevention and control, and diagnosis. Results: The pharmacological studies were more recent controlled trials and had more standardized methods, which lead to production of stronger evidence. Nine randomized, controlled studies for pharmacological treatments were included for this review, and showed that triptans such as sumatriptan and zolmitriptan, as well as dihydroergotamine, were consistently effective in relieving migraine headache pain. The over the counter combination of acetaminophen, aspirin, and caffeine also showed to be beneficial. This review also included nine randomized, controlled studies of alternative treatments, but many were older and revealed more inconsistent conclusions. Results of acupuncture studies were contradicting. Biofeedback and relaxation techniques did show improvement of headache pain, however, a clear difference between the two groups did not emerge. Conclusion: Additional research that directly compares pharmacological treatments to alternative therapies needs to be done to adequately compare the two different treatment modalities. The strongest evidence to date appears to support use of pharmacological treatments