| These meta-analyses explore the effectiveness of several prophylactic treatment modalities for migraine, focusing on covariates that moderate the effectiveness of treatment on migraine severity, duration, and intensity, as well as on the psychological variables of depression and anxiety. Covariates included age, sex, ethnicity/publication location, pain severity, pain frequency, and depression and anxiety severity. The study explored which treatments were most effective for those with comorbid migraine and depression and/or anxiety. Thirty-two articles from February 1992 to February 2016 were included in these analyses. Analyses found significant effects of prophylactic migraine treatment on migraine frequency, migraine index, depression, migraine severity, migraine duration, and anxiety, in descending order of treatment effect. Covariates moderating effectiveness of treatment included pre-treatment depression, pre-treatment migraine severity, sex, publication location, and treatment length on depression severity level; publication location on anxiety; pre-treatment migraine severity and sex on migraine severity; and treatment type on migraine frequency. Findings suggest migraine medications (anticonvulsants, anti-hypertensives, etcetera) have a preferential effect on migraine frequency, followed by multidisciplinary treatment programs/exercise, psychotherapy, surgery, antidepressant medications, and psychophysical treatments. Further, psychotherapy/hypnosis may be a preferred treatment option to indirectly depression in migraineurs. |
