Medical Research

Acupuncture for Migraine Prophylaxis

Kristen Sparrow • June 17, 2019

This is a follow up  to a 2016 study that confirms Acupuncture is a valid preventative for migraines.  As readers know, I have a focus on migraine patients in my clinic. What they were looking at in this study is whether the medications used for comparison were actually useful.
Extremely awkward phrasing that blurs the take away message, but here it is.
For episodic migraine prophylaxis, moderate evidence suggests that acupuncture is “at least non-inferior,” to now-proven, conventional treatments. This raises significant questions in the debate concerning claims that acupuncture is a placebo-based treatment and the prescriptions of proven conventional treatments that have similar effects as acupuncture.
. 2019 Apr 1; 31(2): 85–97.

Systematic Review of Episodic Migraine Prophylaxis: Efficacy of Conventional Treatments Used in Comparisons with Acupuncture

Kien V. Trinh, MD, PhD,1 Dion Diep, BHSc,2 and Kevin Jia Qi Chen, BHSc1
1Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada.
2Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Address correspondence to: Dion Diep, BHSc, Faculty of Medicine, University of Toronto, 1015 Golf Links Road, Ancaster, Ontario L9K 1L6 , Canada ac.otnorotu.liam@peid.noid

Abstract

Objective: A Cochrane Systematic Review published by Linde et al. in 2016 found moderate evidence suggesting that acupuncture is “at least non-inferior” to conventional prophylactic drug treatments (flunarizine, metoprolol, and valproic acid) for episodic migraine prophylaxis. The evidence for the efficacy of these conventional treatments must be verified to strengthen and validate the original comparison made in Linde et al.’s 2016 review. The aim of the current authors’ systematic review was to verify the efficacy of the conventional treatments used in Linde et al.’s 2016 comparison with acupuncture.

Materials and Methods: Search strategies were applied to find studies that could verify the efficacy of conventional treatments for treating episodic migraines. Relevant outcomes and dosages were extracted from the retrieved studies. Each study’s quality was assessed, using the Cochrane’s collaboration tool for assessing risk of bias and the Cochrane GRADE [Grading of Recommendations Assessment, Development, and Evaluation] scale.

Results: There is high-quality evidence suggesting that prophylactic drug treatment, at the treatment dosage ranges used in Linde et al.’s 2016 review, reduced headache frequency at a 3-month follow-up, compared to placebo. Headache frequency at a 6-month follow-up, and responses (at least 50% reduction of headache frequency) at 3-month and 6-month follow-ups could not be assessed.

Conclusions: These findings strengthened Linde et al.’s 2016 comparison of conventional treatments and acupuncture for reducing headache frequency at a 3-month follow-up. For episodic migraine prophylaxis, moderate evidence suggests that acupuncture is “at least non-inferior,” to now-proven, conventional treatments. This raises significant questions in the debate concerning claims that acupuncture is a placebo-based treatment and the prescriptions of proven conventional treatments that have similar effects as acupuncture.

Keywords: migraine prophylaxis, drug therapy, acupuncture