Help for Teen Migraines

June 19, 2002 -- Teens are different from adults. So are their migraine headaches. A pilot study now finds that teens get relief from adult migraine drugs -- but nondrug treatment may work even better.

Teen migraines tend to be shorter than those of adults. That's one reason it's been hard to prove that new migraine drugs work in adolescents. Now a small study shows that these costly drugs do indeed work for teens. At the same time, the study shows that teens do very well with home-based programs that help them prevent and deal with their headaches.

Study leader Constance K. Cottrell, PhD, is project manager for headache treatment research at Ohio University, Athens and Columbus. Her team developed a home-based behavioral therapy program that teaches teens to use a simple biofeedback machine along with relaxation techniques.

"We hope home behavioral therapy will be a cost-effective alternative to drug treatment," Cottrell tells WebMD. "It will be good for kids to manage their migraines without drugs. And there are a lot of parents who don't want their kids taking drugs."

Cottrell compared the home-based program to treatment with the new migraine drugs known as triptans. These drugs include Amerge, Imitrex, Maxalt, and Zomig. They've been a huge help in treating adults with migraine headaches. But Cottrell says they can work much differently in teens.

"Taking these drugs can actually disable the kid for longer than the headache would," she says. "There was one child who slept for 36 hours every time he took a Maxalt. The pain was gone, but it didn't help him live his life."

Still, Cottrell found that the 15 teens who used these drugs got a lot of headache relief. Their headaches went away sooner and they spent far fewer hours unable to perform daily activities.

The 15 teens who got home behavioral therapy did just as well. They, too, spent far fewer hours unable to perform daily activities. They also had fewer migraines each month, fewer days when they had migraines, and a significantly improved quality of life.

"The behavior program taught them to identify their migraine triggers, how to avoid them, how to manage pain when they had it, how to take medications effectively, and how to think differently about headaches so they could manage them better," Cottrell says.

One element of the program is a simple biofeedback machine that uses a small thermometer attached to a person's finger. The idea is to increase temperature in one's fingers, which relaxes the blood vessels in the head and lessens headache pain. Teens caught on to this technique very quickly.

After an initial visit, the teens didn't have to come in to the clinic. Instead, they received a 10-chapter manual with tips on relaxation, biofeedback, and stress management. Once a week, the teens spoke to a psychologist by telephone to go over that week's chapter and to discuss what they'd learned. Cottrell says this was the one part of the program she would change. Many of the kids failed to read their assignments. Perhaps, she says, a videotape or computer program would better hold their interest.