Evaluating the effectiveness of pharmacological interventions versus cognitive behavioral therapy in the treatment of chronic migraine headaches among young adults: a quasi-experimental study

Abstract

ABSTRACT
Background:
Chronic migraine is a disabling neurological condition that affects young adults and disrupts daily functioning, academic performance, productivity, social interactions, and quality of life. Pharmacological therapies are used for prevention and management, while cognitive behavioral therapy offers a structured nonpharmacological approach. Comparative evidence evaluating these interventions in adults remains limited.

Objective:
This study aimed to compare the effectiveness of pharmacological therapy and cognitive behavioral therapy in reducing migraine frequency, pain intensity, and migraine related disability among adults with chronic migraine.
Methodology: A quasi experimental study was conducted among fifty adults diagnosed with chronic migraine who were assigned to either pharmacological treatment or a structured cognitive behavioral therapy program. Outcomes included migraine frequency, pain intensity measured using the Visual Analog Scale, and disability assessed through the Migraine Disability Assessment questionnaire at baseline, eight weeks, and three months follow up. Both groups improved after eight weeks; however, the cognitive behavioral therapy group demonstrated greater reductions in migraine days, pain severity, and disability scores, with sustained benefits over time.

Results:
Both groups showed improvement after intervention, but cognitive behavioral therapy resulted in significantly greater reductions in migraine frequency, pain intensity, and disability scores (p ≤ 0.003). At three months, the pharmacological group showed partial relapse, whereas improvements in the cognitive behavioral therapy group were maintained or further enhanced (p < 0.001).

Conclusion: Cognitive behavioral therapy provides more durable benefits than pharmacological therapy and may be considered an effective alternative or adjunct, highlighting the importance of non-pharmacological strategies in chronic migraine management.