Migraine headache is a painful and often serious problem in the United States. There are many prophylactic pharmacological and nonpharmacological treatments available for migraine headaches. However, choosing between them can be difficult for individuals and treatment providers alike. The primary literature regarding the effectiveness of pharmacological and nonpharmacological treatments is quite dense. More than 191 primary studies were identified as providing information about the effectiveness of one or more treatments for migraine headaches. Of these, 82 articles were retained for meta-analyses on six prophylactic treatments for migraine: propranolol, flunarizine, divalproex sodium, thermal biofeedback, relaxation treatments, and combined treatments. These results suggest that all of the treatments examined have very similar treatment effect sizes. Effect sizes for the reduction of migraine were found to be between .60 and .75 for all treatments. Results suggest that selection of treatment for migraine must be based on more than treatment effectiveness rates alone.

To aid in understanding headache etiology and symptomatology, psychological and physiological variables were examined in patients with migraine and combination headaches (combined migraine and muscle-contraction headaches). One hundred patients being evaluated for treatment of their headaches at The New England Center for Headache participated in this study. They were assigned to the migraine or combination group, based on diagnoses made by three headache specialists—a psychologist, a psychiatrist, and a nuerologist. Personality data from the MMPI and frontalis electromyographic readings reflecting muscle tensions across three stimulus conditions were compared between the two groups. Subjects were also asked to rate the perceived level of stress elicited by the three conditions.