Clinical review: PDF OnlyBehavioral and prophylactic pharmacological intervention studies of pediatric migraine: an exploratory meta-analysisHermann, Christiane; Kim, Mirihae; Blanchard, Edward B.∗Author Information Center for Stress and Anxiety Disorders, SUNY, Albany, NY 12203 USA ∗Corresponding author: Edward B. Blanchard, Ph.D., Center for Stress and Anxiety Disorder, 1535 Western Avenue, Albany, NY 12203, USA. (Received 14 October 1993; revision received 3 October 1994; accepted 6 October 1994.) Pain: March 1995 - Volume 60 - Issue 3 - p 239-255 doi: 10.1016/0304-3959(94)00210-6 Buy Metrics Abstract In this review, the effectiveness of behavioral and pharmacological treatments for pediatric migraine was quantitatively summarized following the meta-analytic approach outlined by Hedges and Olkin (1985). A first meta-analysis based on treatment outcome within treatment conditions revealed that thermal biofeedback and interventions combining biofeedback and progressive muscle relaxation seem to be significantly more efficacious than other behavioral treatment modalities, psychological and drug placebo, and the more commonly used prophylactic drug regimens. Though there is some evidence suggesting good effectiveness of propranolol, the lack of systematic data precludes more definitive conclusions. A second meta-analysis that included only studies providing data on the comparison between control versus active treatment conditions replicated the initial findings only partially. In the light of the relative small number of studies that met basic inclusion requirements, the methodological flaws of many studies, and the under-representation of certain treatment types, conclusions regarding differential effectiveness of the treatment types have to be drawn with caution. Overall, our findings clearly demonstrate the need for direct comparisons between behavioral and pharmacological treatments and the need for more theory-driven research in order to determine the most promising treatment approaches for pediatric migraine. © Lippincott-Raven Publishers.